Provider Demographics
NPI:1629266903
Name:HASSAN SALLOUM MD PA
Entity Type:Organization
Organization Name:HASSAN SALLOUM MD PA
Other - Org Name:WESTWIND PEDIATRIC CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ASSOCIATION MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:HASSAN
Authorized Official - Middle Name:N
Authorized Official - Last Name:SALLOUM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:915-474-5551
Mailing Address - Street 1:7102 WESTWIND DR.
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79912-1726
Mailing Address - Country:US
Mailing Address - Phone:915-581-5100
Mailing Address - Fax:915-581-6100
Practice Address - Street 1:7102 WESTWIND DR.
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79912-1726
Practice Address - Country:US
Practice Address - Phone:915-581-5100
Practice Address - Fax:915-581-6100
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-11
Last Update Date:2009-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty