Provider Demographics
NPI:1386800266
Name:HORMOZDI, BAHRAM (MD)
Entity type:Individual
Prefix:DR
First Name:BAHRAM
Middle Name:
Last Name:HORMOZDI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4410 MEDICAL DR STE 410
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3749
Mailing Address - Country:US
Mailing Address - Phone:210-575-6168
Mailing Address - Fax:210-510-7490
Practice Address - Street 1:7700 FLOYD CURL DR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229
Practice Address - Country:US
Practice Address - Phone:210-575-6168
Practice Address - Fax:210-510-7490
Is Sole Proprietor?:No
Enumeration Date:2008-07-31
Last Update Date:2019-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ23012084N0400X, 2084N0600X, 208M00000X, 208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical Neurophysiology
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX396662YSFSMedicare PIN