Provider Demographics
NPI:1356962450
Name:ALYAMI, AWAD ALI S
Entity type:Individual
Prefix:
First Name:AWAD
Middle Name:ALI S
Last Name:ALYAMI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 S. COULTER STREET
Mailing Address - Street 2:SUITE 1500
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79106-1786
Mailing Address - Country:US
Mailing Address - Phone:806-414-9800
Mailing Address - Fax:806-354-5689
Practice Address - Street 1:1400 S. COULTER STREET
Practice Address - Street 2:SUITE 1500
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79106-1786
Practice Address - Country:US
Practice Address - Phone:806-414-9800
Practice Address - Fax:806-354-5689
Is Sole Proprietor?:No
Enumeration Date:2020-04-29
Last Update Date:2023-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036163821208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics