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General NPI Number Information
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NPI Number | 1801354048
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Entity Type | Individual
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Provider Name | TAYEM ABOU SALEH DDS, MS
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Gender | Male
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Dates
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Enumeration Date | 03/06/2019
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Last Update Date | 02/03/2021
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Provider Practice Location Address
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Address Line | 16789 SAN PEDRO AVE
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City | SAN ANTONIO
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State | TX
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Zip | 78232-2349
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Country | US
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Telephone | 210-494-7660
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Fax |
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Provider Business Mailing Address
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Address Line | 5348 S SUGAR RD APT 2208
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City | EDINBURG
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State | TX
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Zip | 78539-0199
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Country | US
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Telephone | 209-600-8856
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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 | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 34890
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License Number State | TX
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