Basic Information
| Provider Information | |||||||||
| NPI: | 1568930667 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | PALM PLUS PROFESSIONAL SERVICES PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2686 W ALTON GLOOR BLVD STE 3 | ||||||||
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| City: | BROWNSVILLE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 785203839 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9565479561 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2073 RUBEN TORRES SR BLVD | ||||||||
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| City: | BROWNSVILLE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 785260031 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8009623303 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/06/2018 | ||||||||
| LastUpdateDate: | 11/06/2018 | ||||||||
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| AuthorizedOfficialLastName: | HUSSAIN | ||||||||
| AuthorizedOfficialFirstName: | KAZIM | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 9565479552 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.