Provider Demographics
NPI:1942241708
Name:ABOU-FAYCAL, HALIM SALIM (MD)
Entity Type:Individual
Prefix:
First Name:HALIM
Middle Name:SALIM
Last Name:ABOU-FAYCAL
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 1:2551 GREENWOOD RD
Mailing Address - Street 2:SUITE 150
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71103-3981
Mailing Address - Country:US
Mailing Address - Phone:318-212-6888
Mailing Address - Fax:318-212-6890
Practice Address - Street 1:2551 GREENWOOD RD
Practice Address - Street 2:SUITE 150
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71103-3981
Practice Address - Country:US
Practice Address - Phone:318-212-6888
Practice Address - Fax:318-212-6890
Is Sole Proprietor?:No
Enumeration Date:2006-06-10
Last Update Date:2021-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN46329207R00000X, 208M00000X
CO43780207R00000X
LA205782207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
I60427Medicare UPIN
C806229Medicare PIN