MEDICARE: SALAM AL-HAFIDH MD FACP PA

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	207R00000X	Internal Medicine Physician

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	DP9729	OTHER		MEDICARE RAILROAD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0044SJ	OTHER	TX	BCBS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1649500307
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SALAM AL-HAFIDH MD FACP PA

Provider Business Mailing Address
First Line	:	7505 GLENVIEW DR STE 151
Second Line	:
City	:	RICHLAND HILLS
State	:	TX
Zip	:	76180-8335
Country	:	US
Telephone Number	:	817-284-9922
Fax Number	:	817-284-9926

Provider Business Practice Location Address
First Line	:	7505 GLENVIEW DR STE 151
Second Line	:
City	:	RICHLAND HILLS
State	:	TX
Zip	:	76180-8335
Country	:	US
Telephone Number	:	817-284-9922
Fax Number	:	817-284-9926

Authorized Official
Title or Position	:	PRESIDENT
Name	:	SALAM AL-HAFIDH
Credential	:	MD
Telephone Number	:	817-284-9922

Provider Enumeration Date	:	12/31/2009
Last Update Date	:	04/29/2010

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