Provider Demographics
NPI:1881786283
Name:MOHAJER, HOMAYOON (DC)
Entity type:Individual
Prefix:DR
First Name:HOMAYOON
Middle Name:
Last Name:MOHAJER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6423 RICHMOND AVE STE I
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77057-5926
Mailing Address - Country:US
Mailing Address - Phone:713-784-8189
Mailing Address - Fax:713-784-8244
Practice Address - Street 1:6423 RICHMOND AVE STE I
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77057-5926
Practice Address - Country:US
Practice Address - Phone:713-784-8189
Practice Address - Fax:713-784-8244
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6726111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX81Y760OtherBLUE CROSS BLUE SHIELD