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General NPI Number Information
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NPI Number | 1639359466
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Entity Type | Organization
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Legal Business Name | BAYTOWN OCCUPATIONAL & FAMILY MEDICINE P.A.
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Dates
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Enumeration Date | 11/09/2007
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Last Update Date | 01/15/2013
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Provider Practice Location Address
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Address Line | 4002 GARTH ROAD SUITE 150
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City | BAYTOWN
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State | TX
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Zip | 77521-3114
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Country | US
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Telephone | 281-420-4000
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Fax | 281-428-4940
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Provider Business Mailing Address
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Address Line | 4002 GARTH ROAD SUITE 150
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City | BAYTOWN
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State | TX
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Zip | 77521-3114
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Country | US
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Telephone | 281-420-4000
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Fax | 281-428-4940
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Authorized Official
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Title or Position | DOCTOR MD.
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Name | DR. FARIBORZ NAZARI-ADLI
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Credential | M.D.
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Telephone | 281-420-4000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | J7111
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 261QX0100X
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Taxonomy Name | Occupational Medicine Clinic/Center
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License Number | J7111
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | J7111
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License Number State | TX
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