Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QS0010X | Family Doctor - Sports Medicine | ME147716 | FL |
NPI | 1083064844 |
---|---|
Provider Name | Dr. Abdulrahman Baqais |
First Address | Wichita Falls, TX 76301-2245 |
Second Address | Jupiter, FL 33458-4834 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/06/2016 |
Last Update Date | 26/04/2021 |