Provider Demographics
NPI:1730515552
Name:HOSSEINI, BAHAREH (DC)
Entity type:Individual
Prefix:DR
First Name:BAHAREH
Middle Name:
Last Name:HOSSEINI
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1223 W MCDERMOTT DR
Mailing Address - Street 2:SUITE NO. 70
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75013-6412
Mailing Address - Country:US
Mailing Address - Phone:972-649-4747
Mailing Address - Fax:
Practice Address - Street 1:1223 W MCDERMOTT DR
Practice Address - Street 2:SUITE NO. 70
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75013-6412
Practice Address - Country:US
Practice Address - Phone:972-649-4747
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-25
Last Update Date:2016-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12632111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor