Mamad Bagheri MD PA
Dermatology, MOHS-Micrographic Surgery in Wichita Falls, TX. Organization (NPI-2).
NPI number1073055257
StatusActive
Last updated in NPPESNov 5, 2016
Details
- NPI
- 1073055257
- Entity type
- Organization (NPI-2)
- Legal business name
- Mamad Bagheri MD PA
- Organization subpart
- No
- Enumeration date
- Nov 5, 2016
- Last updated
- Nov 5, 2016
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207ND0101X | Dermatology, MOHS-Micrographic Surgery | – | – | Yes |
Practice location
4327 Barnett RdWichita Falls, TX 76310-2303
Phone 951-500-7286
Mailing address
4327 Barnett RdWichita Falls, TX 76310-2303
Phone 951-500-7286
Authorized official
Mamad Bagheri
Sole Member/Owner
9515007286
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