Provider Demographics
NPI:1750691101
Name:MAHMOODUDDIN, SALMA S (MD)
Entity type:Individual
Prefix:
First Name:SALMA
Middle Name:S
Last Name:MAHMOODUDDIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SALMA
Other - Middle Name:
Other - Last Name:SIDDIQUI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:21214 NORTHWEST FREEWAY
Mailing Address - Street 2:PATHOLOGY DEPT.
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77429-3373
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:21214 NORTHWEST FREEWAY
Practice Address - Street 2:PATHOLOGY DEPT.
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77429-3373
Practice Address - Country:US
Practice Address - Phone:713-468-0738
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-19
Last Update Date:2010-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG1089207ZP0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0105XAllopathic & Osteopathic PhysiciansPathologyClinical Pathology/Laboratory Medicine