Healthcare Provider Details

I. General information

NPI: 1780071431
Provider Name (Legal Business Name): SAMEER M ALQASSIMI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/21/2015
Last Update Date: 04/21/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 S COULTER ST
AMARILLO TX
79106-1786
US

IV. Provider business mailing address

520 MAIN ST APT. 1103
MALDEN MA
02148-3903
US

V. Phone/Fax

Practice location:
  • Phone: 806-414-9654
  • Fax:
Mailing address:
  • Phone: 773-510-9689
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: