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General NPI Number Information
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NPI Number | 1811519259
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Entity Type | Individual
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Provider Name | TAREK A BEHERY M.D
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Gender | Male
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Dates
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Enumeration Date | 05/08/2020
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Last Update Date | 11/15/2025
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Provider Practice Location Address
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Address Line | 701 W 5TH ST
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City | ODESSA
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State | TX
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Zip | 79763-4206
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Country | US
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Telephone | 432-703-5011
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Fax |
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Provider Business Mailing Address
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Address Line | 1448 W LEXINGTON ST APT 3
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City | CHICAGO
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State | IL
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Zip | 60607-4014
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Country | US
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Telephone | 614-596-7946
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | W2040
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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