Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | M0554 | TX |
NPI | 1013024579 |
---|---|
Provider Name | Maha S. Salloum |
First Address | El Paso, TX 79912-1726 |
Second Address | El Paso, TX 79912-1726 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/08/2006 |
Last Update Date | 01/07/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
171512001 | (05) | TX |
8H0434 | BC/BS OF TEXAS (01) | TN |
BS9166441 | DEA (01) | TX |