Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204F00000X | Transplant Surgeon | D0067999 | MD |
N | 204F00000X | Transplant Surgeon | Q4097 | TX |
Y | 208200000X | Surgeon | A83958 | CA |
Y | 208600000X | Surgeon | A83958 | CA |
N | 208200000X | Surgeon | MD428478 | PA |
N | 208600000X | Surgeon | MD428478 | PA |
NPI | 1295889202 |
---|---|
Provider Name | Sameh Fayek |
First Address | Dallas, TX 75225-2307 |
Second Address | Torrance, CA 90505-6832 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/01/2007 |
Last Update Date | 19/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
350261907 | (05) | TX |