Individual
TASNIM LAT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
2401 S 31ST ST, TEMPLE, TX 76508-0001
(254) 724-2111
Mailing address
PO BOX 844658, DALLAS, TX 75284-4658
(254) 724-2111
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
R2388
TX
207RS0012X
Sleep Medicine (Internal Medicine) Physician
R2388
TX
Other
Enumeration date
05/13/2014
Last updated
10/01/2020
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