Healthcare Provider Details

I. General information

NPI: 1497955447
Provider Name (Legal Business Name): BEHYAR ZOGHI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2007
Last Update Date: 01/03/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7700 FLOYD CURL DR
SAN ANTONIO TX
78229-3902
US

IV. Provider business mailing address

4450 MEDICAL DR FL 1
SAN ANTONIO TX
78229-3710
US

V. Phone/Fax

Practice location:
  • Phone: 210-575-3817
  • Fax: 210-575-4113
Mailing address:
  • Phone: 210-575-3817
  • Fax: 210-575-4113

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberN7383
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: