Provider Demographics
NPI:1861019648
Name:ALAITHAN, HAITHAM SOROR (MD)
Entity Type:Individual
Prefix:DR
First Name:HAITHAM
Middle Name:SOROR
Last Name:ALAITHAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 BAYLOR PLAZA BCM 410
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030
Mailing Address - Country:US
Mailing Address - Phone:713-798-5808
Mailing Address - Fax:
Practice Address - Street 1:1 BAYLOR PLAZA BCM 410
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030
Practice Address - Country:US
Practice Address - Phone:713-798-5808
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-29
Last Update Date:2023-06-25
Deactivation Date:2022-01-17
Deactivation Code:
Reactivation Date:2022-01-17
Provider Licenses
StateLicense IDTaxonomies
DCMTL005877207R00000X
TXU3454207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine