Organization
BAHAR IMMUNIZATION CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SIAVASH TEHRANI (MEMBER MANAGER)
(832) 878-2044
Entity
Organization
Contact information
Practice address
5200 MITCHELLDALE ST, F-27, HOUSTON, TX 77092-7206
(832) 878-2044
Mailing address
5200 MITCHEDALLE SUITE F-27, HOUSTON, TX 77092
(832) 878-2044
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
—
—
Other
Enumeration date
06/18/2014
Last updated
07/15/2015
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