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General NPI Number Information
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NPI Number | 1053818286
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Entity Type | Individual
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Provider Name | IGAL TARASH DO MD EMBA
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Gender | Male
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Dates
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Enumeration Date | 04/13/2018
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Last Update Date | 09/10/2024
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Provider Practice Location Address
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Address Line | 11937 US HIGHWAY 271
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City | TYLER
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State | TX
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Zip | 75708-3154
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Country | US
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Telephone | 903-877-7168
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Fax | 903-877-8356
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Provider Business Mailing Address
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Address Line | 1966 TICE VALLEY BLVD # 112
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City | WALNUT CREEK
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State | CA
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Zip | 94595-2203
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | S6538
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 19523
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License Number State | CA
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