Provider Demographics
NPI:1649773870
Name:SHEMIRANIPOUR, BARDIA (CES, NASE-CSS)
Entity Type:Individual
Prefix:
First Name:BARDIA
Middle Name:
Last Name:SHEMIRANIPOUR
Suffix:
Gender:M
Credentials:CES, NASE-CSS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8716 LONG POINT RD # 213
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77055-3043
Mailing Address - Country:US
Mailing Address - Phone:281-943-4433
Mailing Address - Fax:832-667-8224
Practice Address - Street 1:8716 LONG POINT RD # 213
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77055-3043
Practice Address - Country:US
Practice Address - Phone:281-943-4433
Practice Address - Fax:832-667-8224
Is Sole Proprietor?:No
Enumeration Date:2018-03-14
Last Update Date:2018-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1437541653OtherNPI TYPE 2