Provider Demographics
NPI:1780810028
Name:BATHAEIAN, AMIR (DC)
Entity type:Individual
Prefix:
First Name:AMIR
Middle Name:
Last Name:BATHAEIAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:AMIR
Other - Middle Name:HOSSEIN
Other - Last Name:BATHAEIAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:950 E. BELTLINE DR.
Mailing Address - Street 2:
Mailing Address - City:CEDER HILL
Mailing Address - State:TX
Mailing Address - Zip Code:75104-2423
Mailing Address - Country:US
Mailing Address - Phone:469-272-7000
Mailing Address - Fax:469-272-3069
Practice Address - Street 1:950 E. BELTLINE DR.
Practice Address - Street 2:
Practice Address - City:CEDER HILL
Practice Address - State:TX
Practice Address - Zip Code:75104-2423
Practice Address - Country:US
Practice Address - Phone:469-272-7000
Practice Address - Fax:469-272-3069
Is Sole Proprietor?:No
Enumeration Date:2009-06-01
Last Update Date:2009-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11072111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor