Provider Demographics
NPI:1720128788
Name:HEYDARI, ABBAS (DC)
Entity type:Individual
Prefix:DR
First Name:ABBAS
Middle Name:
Last Name:HEYDARI
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 1:810 HIGHWAY 6 S STE 204
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77079-4022
Mailing Address - Country:US
Mailing Address - Phone:281-933-6363
Mailing Address - Fax:281-933-8949
Practice Address - Street 1:810 HIGHWAY 6 S STE 204
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77079-4022
Practice Address - Country:US
Practice Address - Phone:281-933-6363
Practice Address - Fax:281-933-8949
Is Sole Proprietor?:No
Enumeration Date:2007-02-07
Last Update Date:2018-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8825111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8G3870OtherBLUE CROSS BLUE SHIELD
TX8G3870OtherBLUE CROSS BLUE SHIELD
U87666Medicare UPIN