Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RA0201X | Internist - Allergy & Immunology | 102726 | TX |
Y | 207RR0500X | Rheumatology | 102726 | TX |
NPI | 1457322869 |
---|---|
Provider Name | Constantine Khalil Saadeh |
First Address | Amarillo, TX 79159-1389 |
Second Address | Amarillo, TX 79124 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/02/2006 |
Last Update Date | 26/06/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
144226101 | (05) | TX |
E55213 | (02) | TX |