Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | M4804 | TX |
N | 111NI0900X | Internist | M4804 | TX |
N | 207RC0200X | Critical Care Medicine | M4804 | TX |
Y | 207RP1001X | Pulmonary Disease | M4804 | TX |
NPI | 1043300148 |
---|---|
Provider Name | Ammar Mohamed-Ali Halloum |
First Address | Harlingen, TX 78550-7840 |
Second Address | Brownsville, TX 78520-7552 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/10/2006 |
Last Update Date | 29/02/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
183807001 | (05) | TX |
183807002 | (05) | TX |
8A9371 | BLUE CROSS BLUE SHIELD (01) | TX |
I68257 | (02) | TX |