Provider Demographics
NPI:1710252598
Name:VICTOR N HAKIM MD PLLC
Entity Type:Organization
Organization Name:VICTOR N HAKIM MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD/SOLE OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:N
Authorized Official - Last Name:HAKIM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:469-443-0924
Mailing Address - Street 1:4001 W 15TH ST
Mailing Address - Street 2:SUITE 290
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-5844
Mailing Address - Country:US
Mailing Address - Phone:469-443-0924
Mailing Address - Fax:469-443-0943
Practice Address - Street 1:4001 W 15TH ST
Practice Address - Street 2:SUITE 290
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-5844
Practice Address - Country:US
Practice Address - Phone:469-443-0924
Practice Address - Fax:469-443-0943
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-13
Last Update Date:2012-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP0597174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB152768Medicare PIN
TXTXB152766Medicare PIN