Provider Demographics
NPI:1437579281
Name:NIKMARD, BAHRAM JOHN
Entity Type:Individual
Prefix:DR
First Name:BAHRAM
Middle Name:JOHN
Last Name:NIKMARD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19810 PARTRIDGE RUN DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77094-3003
Mailing Address - Country:US
Mailing Address - Phone:713-816-3953
Mailing Address - Fax:
Practice Address - Street 1:6818 ATASCOCITA RD
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77346-2817
Practice Address - Country:US
Practice Address - Phone:281-446-4700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-20
Last Update Date:2016-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX31747122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist