Individual
TARANEH BAESMAT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
8476
AZ
363A00000X
Physician Assistant
PA14360
TX
363AM0700X
Medical Physician Assistant
Primary
PA14360
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
093630
—
AZ
Enumeration date
03/31/2021
Last updated
08/26/2024
Update your record
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