Healthcare Provider Details

I. General information

NPI: 1558746743
Provider Name (Legal Business Name): MR. TAMIR SALEEM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2015
Last Update Date: 09/30/2025
Certification Date: 09/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9705 NOLAN RANCH LOOP
GODLEY TX
76044-4381
US

IV. Provider business mailing address

PO BOX 331092
FT WORTH TX
76163-1092
US

V. Phone/Fax

Practice location:
  • Phone: 682-209-0553
  • Fax:
Mailing address:
  • Phone: 682-209-0553
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171W00000X
TaxonomyContractor
License Number
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: