Provider Demographics
NPI:1851367692
Name:RIMLAWI, MICHAEL BASSEM (DO)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:BASSEM
Last Name:RIMLAWI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:221 W COLORADO BLVD
Mailing Address - Street 2:STE 925
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75208-2363
Mailing Address - Country:US
Mailing Address - Phone:214-948-6300
Mailing Address - Fax:214-948-6308
Practice Address - Street 1:221 W COLORADO BLVD
Practice Address - Street 2:SUITE 925, PAVILLION II
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75208-2363
Practice Address - Country:US
Practice Address - Phone:214-948-6300
Practice Address - Fax:214-948-6308
Is Sole Proprietor?:No
Enumeration Date:2006-02-23
Last Update Date:2008-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK7877207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX168291602Medicaid
TX5828380001OtherPALMETTO CIGNA GOVERNMENT SERVICES
TX8F3837Medicare PIN
TX168291602Medicaid