Provider Demographics
NPI:1750452256
Name:RAJA N SALAMEH M D P A
Entity Type:Organization
Organization Name:RAJA N SALAMEH M D P A
Other - Org Name:SALAMEH UROLOGY INSTITUTE
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RAJA
Authorized Official - Middle Name:
Authorized Official - Last Name:SALAMEH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:956-584-2244
Mailing Address - Street 1:910 S BRYAN RD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:MISSION
Mailing Address - State:TX
Mailing Address - Zip Code:78572-6658
Mailing Address - Country:US
Mailing Address - Phone:956-584-2244
Mailing Address - Fax:956-580-2222
Practice Address - Street 1:910 S BRYAN RD
Practice Address - Street 2:SUITE 202
Practice Address - City:MISSION
Practice Address - State:TX
Practice Address - Zip Code:78572-6658
Practice Address - Country:US
Practice Address - Phone:956-584-2244
Practice Address - Fax:956-580-2222
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-13
Last Update Date:2010-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG9654208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1917866Medicaid
TXB64076Medicare UPIN
TX00Y234Medicare PIN