Provider Demographics
NPI:1982458618
Name:BEHNAM MED LLC
Entity Type:Organization
Organization Name:BEHNAM MED LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:BEHNAM
Authorized Official - Middle Name:
Authorized Official - Last Name:HEIDARI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:507-250-7216
Mailing Address - Street 1:11915 RIVERVIEW DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77077-3033
Mailing Address - Country:US
Mailing Address - Phone:507-250-7216
Mailing Address - Fax:
Practice Address - Street 1:11915 RIVERVIEW DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77077-3033
Practice Address - Country:US
Practice Address - Phone:507-250-7216
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-17
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty