PBH Professional Group, P.a.

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

Legal business name

PBH PROFESSIONAL GROUP, P.A.

Practice address

2219 W Euless Blvd Ste 100
Euless, TX 76040-6624

Phone

(817) 857-9110

Fax

(817) 391-3262

NPI assigned

Mar 24, 2021

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Flora F. Sadri-Azarbayejani, D.O.NPI 1023088820

Title

President and Secretary

Phone

(615) 308-7871

Specialties & licenses 4

Addresses

Tax ID family

Path 5Palms Professional Group5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

• PBH Professional Group, P.a.

  dba PATH Brazos Valley Professional Group

  • Addiction Medicine (Preventive Medicine) Physician
  • College Station, TX
  • NPI 1124791744
  NPD tax ID
• PBH Professional Group, P.a.

  dba PATH Worcester Professional Group

  • Multi-Specialty Clinic/Center
  • Worcester, MA
  • NPI 1457945446
  NPD tax ID
• PBH Professional Group, P.a.

  dba PATH 5Palms Professional Group

  • Addiction Medicine (Preventive Medicine) Physician
  • Ormond Beach, FL
  • NPI 1912670647
  NPD tax ID
• PBH Professional Group, P.a.

  dba PATH Nashville Professional Group

  • Addiction Medicine (Preventive Medicine) Physician
  • Nashville, TN
  • NPI 1982273637
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Flora F Sadri-Azarbayejani, DO

  • Addiction Medicine (Preventive Medicine) Physician
  • Lowell, MA
  • NPI 1023088820
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1616544000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616544000000",
    "number": "1932786290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 POWELL CT STE 100",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370275050",
            "telephone_number": "615-308-7871",
            "fax_number": "615-261-8901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2219 W EULESS BLVD STE 100",
            "city": "EULESS",
            "state": "TX",
            "postal_code": "760406624",
            "telephone_number": "817-857-9110",
            "fax_number": "817-391-3262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PBH PROFESSIONAL GROUP, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-24",
        "last_updated": "2021-03-24",
        "certification_date": "2021-03-24",
        "status": "A",
        "authorized_official_last_name": "SADRI-AZARBAYEJANI",
        "authorized_official_first_name": "FLORA",
        "authorized_official_middle_name": "F.",
        "authorized_official_title_or_position": "PRESIDENT AND SECRETARY",
        "authorized_official_telephone_number": "615-308-7871",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207QA0401X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Addiction Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Nurse Practitioner in Euless, TX
• Providers in Euless, TX by specialty
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.