Bagheri, Mamad Mirza

Bagheri, Mamad Mirza is an individual health care provider with primary practice located at 4327 Barnett Rd , Wichita Falls TX 76310-2303. He recently has only one registered license in Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery, which is considered as his primary health care specialty. Bagheri, Mamad Mirza can be contacted via phone (940) 687-3376.

Contact Information

Primary practice address
4327 Barnett Rd Wichita Falls TX 76310-2303
Phone: (940) 687-3376
Fax: (940) 687-3377
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery 207ND0101X Q1792 Texas

Profile Details

NPI number 1467560201
LBN Legal business name Bagheri, Mamad Mirza
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 29th, 2006
Last updated Nov 10th, 2016 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1467560201 NPPES
Other 006759477 AETNA
Other 154H3BA AETNA
Other 686405000 AETNA
Other DF1942 AETNA
Other P00346003 AETNA
Other 27619 AETNA
Other A82406 AETNA
Other P00390315 AETNA
Other ZZZ30167Z AETNA
MEDICAID 14037 AETNA

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