Provider Demographics
NPI:1477527646
Name:AL-ALAMI, BACHAR A (MD)
Entity Type:Individual
Prefix:
First Name:BACHAR
Middle Name:A
Last Name:AL-ALAMI
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 1:3813 22ND STREET SE
Mailing Address - Street 2:SUITE E ATTN: MARY CANTU
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79410-1156
Mailing Address - Country:US
Mailing Address - Phone:806-792-8922
Mailing Address - Fax:
Practice Address - Street 1:3813 22ND STREET SE
Practice Address - Street 2:SUITE E ATTN: MARY CANTU
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79410-1156
Practice Address - Country:US
Practice Address - Phone:806-792-8922
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-15
Last Update Date:2007-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ1179208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP00029840Medicaid
TXP00029840Medicaid