MEDICARE: DR. JUAN ERNESTO BAHAMON 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
1	2084N0400X	Neurology Physician	H3644	TX

Other Identifiers

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

General Provider Information

NPI Number	:	1548376130
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JUAN ERNESTO BAHAMON M.D.

Provider Business Mailing Address
First Line	:	1 COUNTY ROAD 2208 2
Second Line	:
City	:	CLEVELAND
State	:	TX
Zip	:	77327-2309
Country	:	US
Telephone Number	:	210-776-4058
Fax Number	:	361-853-0887

Provider Business Practice Location Address
First Line	:	1 COUNTY ROAD 2208 2
Second Line	:
City	:	CLEVELAND
State	:	TX
Zip	:	77327-2309
Country	:	US
Telephone Number	:	210-776-4058
Fax Number	:

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

Provider Enumeration Date	:	08/23/2006
Last Update Date	:	08/15/2025

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