Provider Demographics
NPI:1841486982
Name:KEYHANI, KOUROSH (DO)
Entity type:Individual
Prefix:DR
First Name:KOUROSH
Middle Name:
Last Name:KEYHANI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11726 GREENBAY DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1631 NORTH LOOP W
Practice Address - Street 2:SUITE 610
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77008-1528
Practice Address - Country:US
Practice Address - Phone:713-486-0800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-22
Last Update Date:2024-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM62252086S0127X, 2086S0129X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
No2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery