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General NPI Number Information
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NPI Number | 1073165395
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Entity Type | Organization
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Legal Business Name | PARHAM BAHADOR, LLC
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Dates
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Enumeration Date | 07/16/2019
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Last Update Date | 07/14/2020
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Provider Practice Location Address
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Address Line | 104 N 3RD ST
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City | ALEXANDRIA
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State | LA
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Zip | 71301-8581
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Country | US
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Telephone | 817-966-3145
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Fax |
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Provider Business Mailing Address
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Address Line | 6509 COLISEUM BLVD UNIT 8
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City | ALEXANDRIA
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State | LA
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Zip | 71303-3763
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | HOSPITALIST
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Name | PARHAM BAHADOR
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Credential |
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Telephone | 817-966-3145
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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