Provider Demographics
NPI:1316150154
Name:BEHDAR, MOHAMMAD RAHIM (DC)
Entity type:Individual
Prefix:
First Name:MOHAMMAD
Middle Name:RAHIM
Last Name:BEHDAR
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17370 PRESTON RD
Mailing Address - Street 2:SUITE 380
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75252-5998
Mailing Address - Country:US
Mailing Address - Phone:214-566-3434
Mailing Address - Fax:972-377-3530
Practice Address - Street 1:17370 PRESTON RD
Practice Address - Street 2:SUITE 380
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75252-5998
Practice Address - Country:US
Practice Address - Phone:214-566-3434
Practice Address - Fax:972-377-3530
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2009-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9389111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1316150154OtherNPI