Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | ME136009 | FL |
N | 2080P0203X | Pediatric Critical Care Doctor | R9853 | TX |
Y | 2080P0203X | Pediatric Critical Care Doctor | R9853 | TX |
NPI | 1205263340 |
---|---|
Provider Name | Tarek Hamad Soliman Salman |
First Address | Mansfield, TX 76063-7833 |
Second Address | Mansfield, TX 76063-7833 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/10/2013 |
Last Update Date | 20/01/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
396882803 | (05) | TX |