Provider Demographics
NPI:1114238953
Name:BARMADA, MOHSEN
Entity type:Individual
Prefix:DR
First Name:MOHSEN
Middle Name:
Last Name:BARMADA
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7101 SAN PEDRO AVE STE A
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78216-6219
Mailing Address - Country:US
Mailing Address - Phone:210-340-2707
Mailing Address - Fax:210-319-5908
Practice Address - Street 1:7101 SAN PEDRO AVE STE A
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78216-6219
Practice Address - Country:US
Practice Address - Phone:210-340-2707
Practice Address - Fax:210-319-5908
Is Sole Proprietor?:No
Enumeration Date:2010-06-26
Last Update Date:2025-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC006187213E00000X
FLPO3607213E00000X
TX2357213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL009159700Medicaid
PA1114238953Medicaid