Individual
FADI NASRALLAH
Active
Individual
FADI NASRALLAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
42125
CO
207L00000X
Anesthesiology Physician
Primary
Q6248
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
352789701
—
TX
05
—
67837557
—
CO
01
—
75-2616977-042
TRICARE
TX
01
—
8FL901
BCBS
TX
01
—
P01569607
RAIL ROAD MEDICARE
TX
Enumeration date
08/20/2006
Last updated
02/08/2016
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