Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RP1001X | Pulmonary Disease | J5821 | TX |
NPI | 1043287022 |
---|---|
Provider Name | Dr. Alfred Salim Maksoud |
First Address | Webster, TX 77598-4146 |
Second Address | Webster, TX 77598 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/03/2006 |
Last Update Date | 11/08/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
04733901 | (05) | TX |
0925908 | AETNA HMO (01) | TX |
10021308 | AMERIGROUP (01) | TX |
5622523 | AETNA EPO-PPO (01) | TX |
760077790 | GROUP TAX ID (01) | TX |
86760Z | RENAISSANCE (01) | TX |
8A2942 | BLUE CROSS BLUE SHIELD (01) | TX |
F55625 | (02) | TX |