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M. Tahir Qayyum, Md, Pmc
Clinic/Center in Bastrop, Louisiana
NPI 1487821708

M. Tahir Qayyum, Md, Pmc is a Clinic/Center based in Bastrop, LA. M. Tahir Qayyum, Md, Pmc practices in Bastrop, LA. The NPI Number for M. Tahir Qayyum, Md, Pmc is 1487821708 and holds a License No. 10850R (Louisiana).

The current practice location address for M. Tahir Qayyum, Md, Pmc is 540 Durham Street, Bastrop, LA and can be reached out via phone at 318-283-2200 and via fax at 318-283-1200.

Location: 540 Durham Street, Bastrop, LA, 71220-5013
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1487821708
Provider Name
M. Tahir Qayyum, Md, Pmc
Credential
Provider Entity Type
Organization
Address
540 Durham Street, Bastrop, LA, 71220-5013
Phone Number
318-283-2200
Fax Number
318-283-1200
Provider Enumeration Date
05/15/2008
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1447111 05 LA
institution
Provider Business Practice Location Address Details
Address
540 Durham Street
City
Bastrop
State
Louisiana
Zip
71220
Phone Number
318-283-2200
Fax Number
318-283-1200
person
Provider Business Mailing Address Details
Address
540 Durham Street
City
Bastrop
State
Louisiana
Zip
71220
Phone Number
318-283-2200
Fax Number
318-283-1200
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
-
Taxonomy
261Q00000X
License No.
10850R (Louisiana)
Definition
A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
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