MEDICARE: BAHAR DIFRANCO M.S.CCC-SLP

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
1	235Z00000X	Speech-Language Pathologist	108704	TX

General Provider Information

NPI Number	:	1518308022
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BAHAR DIFRANCO M.S.CCC-SLP

Provider Business Mailing Address
First Line	:	2907 BLUE LAKES LN
Second Line	:
City	:	MISSOURI CITY
State	:	TX
Zip	:	77459-3072
Country	:	US
Telephone Number	:	512-738-0465
Fax Number	:

Provider Business Practice Location Address
First Line	:	1110 NASA PKWY
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77058-3310
Country	:	US
Telephone Number	:	512-738-0465
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/12/2013
Last Update Date	:	07/12/2013

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Directions to “ BAHAR DIFRANCO M.S.CCC-SLP” Practice Location

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