Individual provider Active NPI

Gholam Zakhireh

  • Oral and Maxillofacial Surgery (Dentist)
  • Houston, TX
National Provider Identifier
1003961483
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
13577 Issued in TX
Practice address
5020 FM 1960 Rd W
Houston, TX 77069-4519
Phone
(281) 580-9058
NPI assigned
Jan 24, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 13577 TX Primary

Addresses

Primary practice location

5020 FM 1960 Rd W
Houston, TX 77069-4519

Mailing address

3701 Kirby Dr
Suite 550
Houston, TX 77098-3900
Phone (281) 580-9058

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160204001636 TX Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 2466756853

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1003961483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3701 KIRBY DR",
            "address_2": "SUITE 550",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770983900",
            "telephone_number": "281-580-9058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5020 FM 1960 RD W",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770694519",
            "telephone_number": "281-580-9058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZAKHIREH",
        "first_name": "GHOLAM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TX",
            "license": "13577",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.