Provider Demographics
NPI:1619152022
Name:AWAD, SALAH AHMED (RTR)
Entity Type:Individual
Prefix:MR
First Name:SALAH
Middle Name:AHMED
Last Name:AWAD
Suffix:
Gender:M
Credentials:RTR
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 60831
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78466-0831
Mailing Address - Country:US
Mailing Address - Phone:361-946-8234
Mailing Address - Fax:361-334-0952
Practice Address - Street 1:6934 VINEYARD DR
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78414-3918
Practice Address - Country:US
Practice Address - Phone:361-946-8234
Practice Address - Fax:361-334-0952
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-03
Last Update Date:2008-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX321690247100000X, 2471B0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471B0102XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistBone Densitometry
No247100000XTechnologists, Technicians & Other Technical Service ProvidersRadiologic Technologist