Provider Demographics
NPI:1972680346
Name:MEYMAND, BAHRAM (DC)
Entity Type:Individual
Prefix:
First Name:BAHRAM
Middle Name:
Last Name:MEYMAND
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14906 SPRING CREEK RD
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75248-5715
Mailing Address - Country:US
Mailing Address - Phone:972-239-1010
Mailing Address - Fax:972-239-5484
Practice Address - Street 1:14906 SPRING CREEK RD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75248-5715
Practice Address - Country:US
Practice Address - Phone:972-239-1010
Practice Address - Fax:972-239-5484
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9030111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX608851OtherBCBS OF TEXAS