Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | 2095 | TX |
N | 213ES0131X | Foot Surgery | 2095 | TX |
NPI | 1326307794 |
---|---|
Provider Name | Dr. Banafsheh Baharloo |
First Address | Houston, TX 77035-2905 |
Second Address | Houston, TX 77035-2905 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/05/2012 |
Last Update Date | 27/05/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
344183401 | (05) | TX |