Individual
DR. TAREQ I. NABHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
12110 SAINT CHARLES ROCK RD, BRIDGETON, MO 63044-2601
(314) 291-3700
Mailing address
12110 SAINT CHARLES ROCK RD, BRIDGETON, MO 63044-2601
(314) 291-3700
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2012020857
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1689921314
—
MO
Enumeration date
08/13/2012
Last updated
02/28/2019
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