Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | N6127 | TX |
Y | 208600000X | Surgeon | N6127 | TX |
N | 2086S0127X | Trauma Surgeon | N6127 | TX |
NPI | 1053510339 |
---|---|
Provider Name | Dr. Kareem Reda Abdelfattah |
First Address | Dallas, TX 75284-5347 |
Second Address | Dallas, TX 75390-7208 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/07/2007 |
Last Update Date | 16/11/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
BP1-0028828 | INSTITUTIONAL PERMIT (01) |