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Individual

TAHIR M QAYYUM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
540 DURHAM ST, BASTROP, LA 71220-5013
(318) 283-2200
(318) 283-1200
Mailing address
540 DURHAM ST, BASTROP, LA 71220-5013
(318) 283-2200
(318) 283-1200

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
10850R
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
080144244
RAILROAD MEDICARE
LA
05
1680061
LA
Enumeration date
09/25/2006
Last updated
10/13/2025
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