Provider Demographics
NPI:1225109648
Name:SALEEMI, SAROSH (M D)
Entity Type:Individual
Prefix:
First Name:SAROSH
Middle Name:
Last Name:SALEEMI
Suffix:
Gender:F
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6618 SITIO DEL RIO BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78730-1143
Mailing Address - Country:US
Mailing Address - Phone:512-795-7575
Mailing Address - Fax:855-307-9139
Practice Address - Street 1:6618 SITIO DEL RIO BLVD STE 101
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78730
Practice Address - Country:US
Practice Address - Phone:512-795-7575
Practice Address - Fax:855-307-9139
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-10
Last Update Date:2018-08-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXL4689207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX613913Medicare PIN