Provider Demographics
NPI:1174770382
Name:BOZORGCHAMI, HORMOZD (MD)
Entity type:Individual
Prefix:DR
First Name:HORMOZD
Middle Name:
Last Name:BOZORGCHAMI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17198 ST LUKES WAY STE 600
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77384-8017
Mailing Address - Country:US
Mailing Address - Phone:936-266-2450
Mailing Address - Fax:936-266-8602
Practice Address - Street 1:17198 ST LUKES WAY STE 600
Practice Address - Street 2:
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77384-8017
Practice Address - Country:US
Practice Address - Phone:936-266-2450
Practice Address - Fax:936-266-8602
Is Sole Proprietor?:No
Enumeration Date:2008-08-20
Last Update Date:2022-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR7675207T00000X, 2084V0102X, 2085R0204X, 2084N0400X
ORMD1538622084N0400X, 2084V0102X
CAA1058122084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
No2084V0102XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyVascular Neurology
No2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology