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General NPI Number Information
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NPI Number | 1760457147
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Entity Type | Individual
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Provider Name | IHSAN M SALLOUM MD
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Gender | Male
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Dates
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Enumeration Date | 02/21/2006
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Last Update Date | 12/14/2021
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Provider Practice Location Address
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Address Line | 2902 HAINE DRIVE
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City | HARLINGEN
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State | TX
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Zip | 78550
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Country | US
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Telephone | 956-296-4000
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Fax | 956-296-2842
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Provider Business Mailing Address
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Address Line | 2102 TREASURE HILLS BLVD STE 2.126
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City | HARLINGEN
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State | TX
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Zip | 78550-8736
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Country | US
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Telephone | 956-296-5527
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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 | ME98860
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | S6731
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License Number State | TX
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