Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | L1270 | TX |
N | 207YS0123X | Facial Plastic Surgeon | L1270 | TX |
NPI | 1881672285 |
---|---|
Provider Name | Dr. Salim Bhaloo |
First Address | Fort Worth, TX 76161-1205 |
Second Address | Granbury, TX 76049-7475 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/01/2006 |
Last Update Date | 03/11/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
171536901 | (05) | TX |
8F0718 | BCBS (01) | TX |
I18286 | (02) | TX |