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NPI Code Detail

MEDICARE: DR. MAHNAZ BAGHERPOUR DDS

MEDICARE: DR. MAHNAZ BAGHERPOUR DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry39092TX

General Provider Information

NPI Number : 1821211798
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MAHNAZ BAGHERPOUR DDS
Provider Business Mailing Address
First Line : 7112 ED BLUESTEIN BLVD STE 130
Second Line :
City : AUSTIN
State : TX
Zip : 78723-2924
Country : US
Telephone Number : 512-926-7001
Fax Number : 512-926-7040
Provider Business Practice Location Address
First Line : 7112 ED BLUESTEIN BLVD STE 130
Second Line :
City : AUSTIN
State : TX
Zip : 78723-2924
Country : US
Telephone Number : 512-926-7001
Fax Number : 512-926-7040
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/10/2007
Last Update Date : 12/26/2024

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