Provider Demographics
NPI:1982659025
Name:BACHMAN, TERESA ROSE (MD)
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:ROSE
Last Name:BACHMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 COUNTRY ESTATES CIR
Mailing Address - Street 2:SUITE #2
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89511-4040
Mailing Address - Country:US
Mailing Address - Phone:775-322-9100
Mailing Address - Fax:775-851-4448
Practice Address - Street 1:160 COUNTRY ESTATES CIR
Practice Address - Street 2:SUITE #2
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89511-4040
Practice Address - Country:US
Practice Address - Phone:775-322-9100
Practice Address - Fax:775-851-4448
Is Sole Proprietor?:No
Enumeration Date:2006-05-24
Last Update Date:2009-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV7429174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE002016610Medicaid
NE002016610Medicaid
NE32008Medicare ID - Type UnspecifiedMEDICARE NUMBER