MEDICARE: DR. TARIQ ELAGAMY DPM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program	692294	TX

General Provider Information

NPI Number	:	1003436486
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TARIQ ELAGAMY DPM

Provider Business Mailing Address
First Line	:	5323 HARRY HINES BOULEVARD DALLAS TEXAS 75390
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75390-0001
Country	:	US
Telephone Number	:	214-648-3433
Fax Number	:

Provider Business Practice Location Address
First Line	:	5323 HARRY HINES BOULEVARD DALLAS TEXAS 75390
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75390-0001
Country	:	US
Telephone Number	:	214-648-3433
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/25/2020
Last Update Date	:	05/06/2026

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