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NPI Code Detail

MEDICARE: LADAN BAKHTARI M.D.

MEDICARE: LADAN BAKHTARI M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine PhysicianJ8447TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
283881YOTHERTXBCBS

General Provider Information

NPI Number : 1275602799
Entity Type Code : Individual
Provider Name (Legal Business Name) : LADAN BAKHTARI M.D.
Provider Business Mailing Address
First Line : 5941 DALLAS PKWY
Second Line :
City : PLANO
State : TX
Zip : 75093-9001
Country : US
Telephone Number : 972-758-4455
Fax Number : 972-758-4433
Provider Business Practice Location Address
First Line : 5941 DALLAS PKWY
Second Line :
City : PLANO
State : TX
Zip : 75093-9001
Country : US
Telephone Number : 972-758-4455
Fax Number : 972-758-4433
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/07/2006
Last Update Date : 03/06/2008

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Directions to “ LADAN BAKHTARI M.D.” Practice Location

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