Provider Demographics
NPI:1730348749
Name:NIKBAKHT, MARK (MD)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:
Last Name:NIKBAKHT
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:301 UNIVERSITY BLVD
Mailing Address - Street 2:
Mailing Address - City:GALVESTON
Mailing Address - State:TX
Mailing Address - Zip Code:77555-5302
Mailing Address - Country:US
Mailing Address - Phone:409-772-7118
Mailing Address - Fax:409-772-9068
Practice Address - Street 1:UNIVERSITY OF TEXAS MEDICAL BR
Practice Address - Street 2:301 UNIVERSITY BLVD
Practice Address - City:GALVESTON
Practice Address - State:TX
Practice Address - Zip Code:77555-0001
Practice Address - Country:US
Practice Address - Phone:409-772-7118
Practice Address - Fax:409-772-9068
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-04
Last Update Date:2013-04-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXBP1-0031978207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine