Healthcare Provider Details

I. General information

NPI: 1679772966
Provider Name (Legal Business Name): ADNAN ABDULKARIM ALATOOM MD, PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/16/2007
Last Update Date: 07/24/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5323 HARRY HINES BLVD.
DALLAS TX
75390
US

IV. Provider business mailing address

P.O. BOX 845347
DALLAS TX
75284
US

V. Phone/Fax

Practice location:
  • Phone: 214-645-0355
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code207ZM0300X
TaxonomyMedical Microbiology Physician
License NumberP3846
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code207ZP0105X
TaxonomyClinical Pathology/Laboratory Medicine Physician
License Number104999
License Number StateMN
# 4
Primary TaxonomyN
Taxonomy Code207ZP0105X
TaxonomyClinical Pathology/Laboratory Medicine Physician
License Number53256
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: