Provider Demographics
NPI:1821157942
Name:SAIFI, MARYAM (MD)
Entity Type:Individual
Prefix:DR
First Name:MARYAM
Middle Name:
Last Name:SAIFI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 MEDICAL PKWY STE 204
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75234-7845
Mailing Address - Country:US
Mailing Address - Phone:972-661-9197
Mailing Address - Fax:972-239-5526
Practice Address - Street 1:10 MEDICAL PKWY STE 204
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75234
Practice Address - Country:US
Practice Address - Phone:972-661-9197
Practice Address - Fax:972-239-5526
Is Sole Proprietor?:No
Enumeration Date:2006-12-06
Last Update Date:2018-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM2069208000000X, 390200000X, 207K00000X
CAA96121208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX179206105Medicaid
TX179206107Medicaid
TX179206106Medicaid
TX179206104Medicaid
TX321859601Medicaid