Individual
SEPEHR BAHADORANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
701 S ZARZAMORA ST, SAN ANTONIO, TX 78207-5209
(210) 358-7600
(210) 358-7623
Mailing address
701 S ZARZAMORA ST, SAN ANTONIO, TX 78207-5209
(210) 358-7600
(210) 358-7623
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
4301105348
MI
207W00000X
Ophthalmology Physician
R9465
TX
207WX0107X
Retina Specialist (Ophthalmology) Physician
Primary
R9465
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
411918201
—
TX
01
—
411918202
CSHCN
TX
Enumeration date
06/16/2015
Last updated
11/22/2021
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