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NPI Code Detail

MEDICARE: JULIA ANNE BAHASH LD

MEDICARE: JULIA ANNE BAHASH LD
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
1133V00000XRegistered Dietitian2791OK

General Provider Information

NPI Number : 1922961770
Entity Type Code : Individual
Provider Name (Legal Business Name) : JULIA ANNE BAHASH LD
Provider Business Mailing Address
First Line : 1200 E PECAN ST
Second Line :
City : ALTUS
State : OK
Zip : 73521-6192
Country : US
Telephone Number : 580-379-5000
Fax Number : 580-379-5509
Provider Business Practice Location Address
First Line : 1200 E PECAN ST
Second Line :
City : ALTUS
State : OK
Zip : 73521-6192
Country : US
Telephone Number : 580-379-5000
Fax Number : 580-379-5509
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/08/2025
Last Update Date : 12/08/2025

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