Provider Demographics
NPI:1487650487
Name:SALOUM, MAHER (MD)
Entity Type:Individual
Prefix:
First Name:MAHER
Middle Name:
Last Name:SALOUM
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 1:8235 S NEW BRAUNFELS STE 101
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78235-4439
Mailing Address - Country:US
Mailing Address - Phone:210-616-1317
Mailing Address - Fax:
Practice Address - Street 1:8235 S NEW BRAUNFELS STE 101
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78235-4439
Practice Address - Country:US
Practice Address - Phone:210-616-1317
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-06-23
Last Update Date:2021-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00043381207R00000X
TXN4060207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00141129OtherRR MEDICARE
WA0186015OtherLABOR & IND.
OR233052Medicaid
WA8397788Medicaid
WA8938463OtherCRIME VICTIMS
WA8804071Medicare PIN
WA8938463OtherCRIME VICTIMS