1598751794 NPI number — BECHARA MEZHER MD

Table of content: BECHARA MEZHER MD (NPI 1598751794)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1598751794 NPI number — BECHARA MEZHER MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MEZHER
Provider First Name:
BECHARA
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1598751794
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/18/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1505 N SWAN RD STE 121
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TUCSON
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
85712-4044
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
520-795-3090
Provider Business Mailing Address Fax Number:
520-795-3537

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1505 N SWAN RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TUCSON
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85712
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
520-869-9233
Provider Business Practice Location Address Fax Number:
888-422-9903
Provider Enumeration Date:
09/22/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207RG0100X , with the licence number:  28951 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: MD2023-1621 . This is a "NM LICENSE" identifier , issued by the state of ( NM ) . This identifiers is of the category "OTHER".
  • Identifier: 703448 , issued by the state of ( AZ ) . This identifiers is of the category "MEDICAID".




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