Individual ProviderAhmad GoodarziInternal MedicineAllopathic & Osteopathic PhysiciansPractice Address6550 Fannin St, Suite 1101, Houston, TX 77030-2717(713) 441-0006PECOS EnrollmentBased on the most recent information from CMS, provider Ahmad Goodarzi is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records yesterday at 8:41 AM.Profile DetailsProvider ID1992012173Provider TypeIndividualFull NameGoodarzi, AhmadCredentialM.D.GenderMaleSole ProprietorNoEnumeration Date9/9/2010Last Updated10/19/2017Contact InformationPractice LocationPractice Address6550 Fannin St, Suite 1101, Houston, TX 77030-2717Phone(713) 441-0006Fax(713) 790-2727Mailing LocationMailing Address6550 Fannin St, Suite 1101, Houston, TX 77030-2717Phone(713) 441-0006Fax(713) 790-2727Provider TaxonomiesCodeDescriptionLicenseCode207RP1001XPrimaryDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicenseP2861TexasCode207R00000XDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicense246560MassachusettsCode207R00000XDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicenseP2861TexasProvider IdentifiersIDDescriptionIssuerID338330904DescriptionOtherIssuerCSHCN SERVICES PROGRAMTexasID8FC773DescriptionOtherIssuerBLUE CROSS BLUE SHIELDTexasID338330902DescriptionMedicaidIssuerUnlistedTexasID338330903DescriptionMedicaidIssuerUnlistedTexasID8FX368DescriptionOtherIssuerBLUE CROSS BLUE SHIELDTexas