Healthcare Provider Details

I. General information

NPI: 1992145163
Provider Name (Legal Business Name): HAMMAD BOKHARI D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/02/2013
Last Update Date: 11/20/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6431 FANNIN ST STE 1014
HOUSTON TX
77030
US

IV. Provider business mailing address

1885 EL PASEO ST APT 611
HOUSTON TX
77054-3046
US

V. Phone/Fax

Practice location:
  • Phone: 713-500-7100
  • Fax:
Mailing address:
  • Phone: 248-303-4510
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberR3477
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code2084N0600X
TaxonomyClinical Neurophysiology Physician
License NumberR3477
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: