Basic Information
| Provider Information | |||||||||
| NPI: | 1316326705 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | THALJI | ||||||||
| FirstName: | NASSIR | ||||||||
| MiddleName: | MAATH AHMAD | ||||||||
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| Credential: | MBCHB | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8201 EWING HALSELL DR FL 2 | ||||||||
| Address2: | |||||||||
| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782293707 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 1057548372 | ||||||||
| FaxNumber: | 2105758480 | ||||||||
| Practice Location | |||||||||
| Address1: | 8201 EWING HALSELL DR FL 2 | ||||||||
| Address2: | |||||||||
| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782293707 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2105754837 | ||||||||
| FaxNumber: | 2105758480 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/19/2015 | ||||||||
| LastUpdateDate: | 08/28/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/28/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | T9514 | TX | N | Allopathic & Osteopathic Physicians | Surgery | 204F00000X | T9514 | TX | Y | Allopathic & Osteopathic Physicians | Transplant Surgery |
No ID Information.