Individual
MS. KATAYOUN JANE BAHRAMI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ACNP-BC
Contact information
Practice address
448 CASTROVILLE RD, SAN ANTONIO, TX 78207-5147
(210) 434-1400
(210) 431-7472
Mailing address
448 CASTROVILLE RD, SAN ANTONIO, TX 78207-5147
(210) 434-1400
(210) 431-7472
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
616273
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2171662-02
WELLMED MEDICAID
TX
01
—
347552YLPS
WELLMED MEDICARE
TX
Enumeration date
10/13/2010
Last updated
09/13/2021
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