Provider Demographics
NPI:1194905307
Name:GREATER HOUSTON NEUROSURGICAL ASSOCIATION
Entity type:Organization
Organization Name:GREATER HOUSTON NEUROSURGICAL ASSOCIATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MAHMOOD
Authorized Official - Middle Name:
Authorized Official - Last Name:MORADI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-464-6245
Mailing Address - Street 1:920 FROSTWOOD DR
Mailing Address - Street 2:SUITE 625
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-2414
Mailing Address - Country:US
Mailing Address - Phone:713-464-6624
Mailing Address - Fax:
Practice Address - Street 1:920 FROSTWOOD DR
Practice Address - Street 2:SUITE 625
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-2414
Practice Address - Country:US
Practice Address - Phone:713-464-6624
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-06
Last Update Date:2007-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ0142207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0097BHMedicare PIN