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General NPI Number Information
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NPI Number | 1922523042
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Entity Type | Organization
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Legal Business Name | BNA MEDICAL GROUP, INC
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Dates
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Enumeration Date | 08/09/2017
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Last Update Date | 07/13/2021
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Provider Practice Location Address
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Address Line | 150 BRAND RD STE 700
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City | MURPHY
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State | TX
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Zip | 75094-3734
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Country | US
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Telephone | 469-445-2445
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Fax |
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Provider Business Mailing Address
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Address Line | 3515 ARISTA BLVD APT 27
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City | TEXARKANA
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State | TX
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Zip | 75503-1196
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Country | US
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Telephone | 973-573-1774
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | BASHAR NIMAN ALSHAREEF
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Credential | MD
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Telephone | 973-573-1774
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P2900X
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Taxonomy Name | Pain Medicine (Psychiatry & Neurology) Physician
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License Number | P0534
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License Number State | TX
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