Provider Demographics
NPI:1710061361
Name:DAHR, NAHLA A (MD)
Entity Type:Individual
Prefix:DR
First Name:NAHLA
Middle Name:A
Last Name:DAHR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:NAHLA
Other - Middle Name:
Other - Last Name:DAHR-MALEK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:2000 OPELOUSAS STREET
Mailing Address - Street 2:
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70601
Mailing Address - Country:US
Mailing Address - Phone:337-439-9983
Mailing Address - Fax:337-439-3224
Practice Address - Street 1:500 PATTERSON STREET
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70601
Practice Address - Country:US
Practice Address - Phone:337-769-9451
Practice Address - Fax:337-769-9460
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2013-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA12675R208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA53960Medicaid
G74955Medicare UPIN