Provider Demographics
NPI:1548236813
Name:NAGUIB, TAREK H (MD)
Entity Type:Individual
Prefix:
First Name:TAREK
Middle Name:H
Last Name:NAGUIB
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1215 S COULTER ST
Mailing Address - Street 2:SUITE 404
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79106-1758
Mailing Address - Country:US
Mailing Address - Phone:806-358-8477
Mailing Address - Fax:806-677-7639
Practice Address - Street 1:1215 S COULTER ST
Practice Address - Street 2:SUITE 404
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79106-1758
Practice Address - Country:US
Practice Address - Phone:806-358-8477
Practice Address - Fax:806-677-7639
Is Sole Proprietor?:No
Enumeration Date:2006-02-27
Last Update Date:2015-10-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OK17465207RI0200X, 207RN0300X
TXN0304207RI0200X, 207RN0300X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100143010AMedicaid
NM52375544Medicaid
TX200042403Medicaid
TX200042402Medicaid
TX200042403Medicaid
TX415961YM74Medicare PIN