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General NPI Number Information
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NPI Number | 1558178871
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Entity Type | Organization
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Legal Business Name | BACHIMD, P.A.
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Dates
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Enumeration Date | 12/11/2024
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Last Update Date | 12/11/2024
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Provider Practice Location Address
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Address Line | 763 E US HIGHWAY 80 STE 230
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City | FORNEY
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State | TX
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Zip | 75126-8682
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Country | US
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Telephone | 805-210-5491
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Fax |
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Provider Business Mailing Address
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Address Line | 763 E US HIGHWAY 80 STE 230
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City | FORNEY
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State | TX
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Zip | 75126-8682
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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 | OWNER
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Name | KENNY ILOABACHIE
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Credential | MD
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Telephone | 805-210-5491
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number |
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License Number State |
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