Provider Demographics
NPI:1093708752
Name:BAHR, DOUGLAS FREDERICK (MD)
Entity Type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:FREDERICK
Last Name:BAHR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2961 MOSSROCK
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78230-5119
Mailing Address - Country:US
Mailing Address - Phone:210-731-4800
Mailing Address - Fax:210-731-4810
Practice Address - Street 1:990 LOOP 337
Practice Address - Street 2:
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78130-3521
Practice Address - Country:US
Practice Address - Phone:830-515-1280
Practice Address - Fax:830-515-1963
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-29
Last Update Date:2021-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH0149207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX097186302Medicaid
TX00A19HMedicare PIN
B21059Medicare UPIN