Organization · Type 2 NPI
M. Tahir Qayyum, Md, PMC
Clinic/Center · Bastrop, LA
NPI number
1487821708
Active
Practice location
540 Durham Street
Bastrop, LA 71220
Fax (318) 283-1200
Mailing address
540 Durham St
Bastrop, LA 71220-5013
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Clinic/Center Primary | 261Q00000X | 10850R (LA) |
Clinic/Center: 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).
Other clinic/center providers in Bastrop
About NPI 1487821708
M. Tahir Qayyum, Md, PMC's National Provider Identifier is 1487821708, issued on May 15, 2008. The primary taxonomy on file is Clinic/Center (261Q00000X), and the practice location is in Bastrop, LA. The record was last updated on Oct 13, 2025.