M. TAHIR QAYYUM MD PMC NPI 1487821708

NPI Information

  • NPI: 1487821708
  • Provider Name: M. TAHIR QAYYUM, MD, PMC
  • Classification: Clinic/Center - 261Q00000X
  • Entity Type: Organization
  • Doing Business As: FAMILY MEDICINE CENTER
  • Address: 540 DURHAM STREET
    BASTROP, LA
    ZIP 71220
  • Phone: (318) 283-2200

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NPI Details

M. TAHIR QAYYUM, MD, PMC is a clinic center in Bastrop, LA. The provider is 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). M. TAHIR QAYYUM, MD, PMC NPI is 1487821708. The provider is registered as an organization entity type.
The provider Is Doing Business As Family Medicine Center.

The provider's business location address is:

540 DURHAM STREET
BASTROP, LA
ZIP 71220
Phone: (318) 283-2200
Fax: (318) 283-1200

The provider's authorized official is M. Tahir Qayyum .
The authorized official title is Owner and has the following contact phone number (318) 283-2200.

The enumeration date for this NPI number is 5/15/2008 and was last updated on 10/22/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261Q00000XClinic/Center10850RLOUISIANAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1G39735MEDICARE UPINLOUISIANA
21447111MEDICAIDLOUISIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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