Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2086S0129X | Vascular Surgeon | BP10057072 | TX |
Y | 2086S0129X | Vascular Surgeon | T2939 | TX |
NPI | 1023467461 |
---|---|
Provider Name | Tammam Obeid |
First Address | Mesquite, TX 75150-2601 |
Second Address | Mesquite, TX 75150-2601 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/06/2016 |
Last Update Date | 14/09/2021 |