Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0202X | Pediatric Cardiologist | L1728 | TX |
NPI | 1154378669 |
---|---|
Provider Name | Mehrdad Salamat |
First Address | Corpus Christi, TX 78466-8466 |
Second Address | Corpus Christi, TX 78414 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/05/2006 |
Last Update Date | 07/03/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
120044 | SUPERIOR HEALTHPLAN (01) | TX |
141268602 | (05) | TX |
141268602 | CSHCN (01) | TX |
8H9853 | BCBSTX (01) | TX |
H31471 | (02) | TX |