Provider Demographics
NPI:1558746743
Name:SALEEM, TAMIR
Entity Type:Individual
Prefix:MR
First Name:TAMIR
Middle Name:
Last Name:SALEEM
Suffix:
Gender:M
Credentials:
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 331092
Mailing Address - Street 2:
Mailing Address - City:FT. WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76163
Mailing Address - Country:US
Mailing Address - Phone:682-209-0553
Mailing Address - Fax:817-526-5093
Practice Address - Street 1:6012 BLACK SPRINGS LANE
Practice Address - Street 2:
Practice Address - City:JOSHUA
Practice Address - State:TX
Practice Address - Zip Code:76058
Practice Address - Country:US
Practice Address - Phone:682-209-0553
Practice Address - Fax:817-526-5093
Is Sole Proprietor?:No
Enumeration Date:2015-07-29
Last Update Date:2015-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor