Individual
MARK ALI BAHREINI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
6928 AMETHYST LN, PLANO, TX 75023-1938
(214) 714-4782
Mailing address
6928 AMETHYST LN, PLANO, TX 75023-1938
(214) 714-4782
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA11374
TX
363AS0400X
Surgical Physician Assistant
PA11474
TX
Other
Enumeration date
08/12/2017
Last updated
07/21/2022
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