Provider Demographics
NPI:1417921727
Name:JABBOUR, SALIM H (MD)
Entity Type:Individual
Prefix:DR
First Name:SALIM
Middle Name:H
Last Name:JABBOUR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 260249
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75026-0249
Mailing Address - Country:US
Mailing Address - Phone:972-612-0430
Mailing Address - Fax:
Practice Address - Street 1:1705 OHIO DR
Practice Address - Street 2:SUITE 100
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-5255
Practice Address - Country:US
Practice Address - Phone:972-612-0430
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-14
Last Update Date:2014-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK4716208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX280001153OtherMEDICARE RAILROAD
TX153986801Medicaid
TX8A7551OtherBCBS
TX280001153OtherMEDICARE RAILROAD
TX8A7551OtherBCBS