Provider Demographics
NPI:1376552018
Name:TAMIMI, RAED R (MD)
Entity Type:Individual
Prefix:DR
First Name:RAED
Middle Name:R
Last Name:TAMIMI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:6016 TRIBUTARY RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-5178
Mailing Address - Country:US
Mailing Address - Phone:512-389-1010
Mailing Address - Fax:512-389-6544
Practice Address - Street 1:1901 S 1ST ST
Practice Address - Street 2:AUSTIN OPC
Practice Address - City:TEMPLE
Practice Address - State:TX
Practice Address - Zip Code:76504-7451
Practice Address - Country:US
Practice Address - Phone:512-389-1010
Practice Address - Fax:512-389-6522
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXJ59222084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry