Basic Information
Provider Information | |||||||||
NPI: | 1093120941 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | ALMASARWEH | ||||||||
FirstName: | SALEEM | ||||||||
MiddleName: | ISSA | ||||||||
NamePrefix: |   | ||||||||
NameSuffix: |   | ||||||||
Credential: | M.D | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 315 N SAN SABA STE 1135 | ||||||||
Address2: |   | ||||||||
City: | SAN ANTONIO | ||||||||
State: | TX | ||||||||
PostalCode: | 782073255 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 2107044580 | ||||||||
FaxNumber: |   | ||||||||
Practice Location | |||||||||
Address1: | 333 N SANTA ROSA | ||||||||
Address2: |   | ||||||||
City: | SAN ANTONIO | ||||||||
State: | TX | ||||||||
PostalCode: | 782073108 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 7137981750 | ||||||||
FaxNumber: | 7137984693 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 06/29/2014 | ||||||||
LastUpdateDate: | 04/21/2022 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | M | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: | 04/21/2022 |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | 135810 | FL | N |   | Allopathic & Osteopathic Physicians | Pediatrics |   | 208000000X | T6506 | TX | N |   | Allopathic & Osteopathic Physicians | Pediatrics |   | 2080P0202X | T6506 | TX | Y |   | Allopathic & Osteopathic Physicians | Pediatrics | Pediatric Cardiology |
No ID Information.