| Leila G. Vizirov, M.d., P.a. | |
|
1631 North Loop W Suite 480 Houston TX 77008-1500 | |
| (713) 869-4404 | |
| (713) 869-4415 |
| Full Name | Leila G. Vizirov, M.d., P.a. |
|---|---|
| Speciality | Family Medicine |
| Location | 1631 North Loop W, Houston, Texas |
| Authorized Official Name and Position | Leila G. Vizirov (OWNER/PRESIDENT) |
| Authorized Official Contact | 7138694404 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Leila G. Vizirov, M.d., P.a. Po Box 926107 Houston TX 77292-6107 Ph: (713) 869-4404 | Leila G. Vizirov, M.d., P.a. 1631 North Loop W Suite 480 Houston TX 77008-1500 Ph: (713) 869-4404 |
| NPI Number | 1174627764 |
|---|---|
| Provider Enumeration Date | 09/12/2006 |
| Last Update Date | 10/04/2007 |
| Medicare PECOS PAC ID | 8628035086 |
|---|---|
| Medicare Enrollment ID | O20041216000937 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174627764 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Leila G Vizirov |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770571895 PECOS PAC ID: 2062304462 Enrollment ID: I20040329001552 |
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