1598778201 NPI number — DR. SUHAIL S. AL-SAHLI

Table of content: DR. SUHAIL S. AL-SAHLI (NPI 1598778201)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1598778201 NPI number — DR. SUHAIL S. AL-SAHLI

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
AL-SAHLI
Provider First Name:
SUHAIL
Provider Middle Name:
S.
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
AL-SAHLI
Provider Other First Name:
SUHAIL
Provider Other Middle Name:
S.
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
D.C.
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1598778201
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1210 NASA PKWY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HOUSTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77058
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
281-333-1377
Provider Business Mailing Address Fax Number:
281-333-0442

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1210A NASA PKWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77058-3304
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
281-333-1377
Provider Business Practice Location Address Fax Number:
281-333-0442
Provider Enumeration Date:
08/14/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 111NX0100X , with the licence number:  DC6951 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: C06055959 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




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