Provider Demographics
NPI:1831131606
Name:VAWDA, SALMA (MD)
Entity Type:Individual
Prefix:
First Name:SALMA
Middle Name:
Last Name:VAWDA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SALMA
Other - Middle Name:
Other - Last Name:OMER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 66308
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77266-6308
Mailing Address - Country:US
Mailing Address - Phone:713-830-3060
Mailing Address - Fax:713-523-4897
Practice Address - Street 1:6441 HIGH STAR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074
Practice Address - Country:US
Practice Address - Phone:713-779-6400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-13
Last Update Date:2014-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK3514208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX059574602Medicaid