Provider Demographics
NPI:1730355702
Name:KHADERI, SAIRA AIJAZ (MD)
Entity type:Individual
Prefix:
First Name:SAIRA
Middle Name:AIJAZ
Last Name:KHADERI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6620 MAIN ST
Mailing Address - Street 2:SUITE 1425
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2348
Mailing Address - Country:US
Mailing Address - Phone:832-355-1400
Mailing Address - Fax:
Practice Address - Street 1:6620 MAIN ST
Practice Address - Street 2:SUITE 1425
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2348
Practice Address - Country:US
Practice Address - Phone:832-355-1400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-30
Last Update Date:2015-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH57-010333207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine