Provider Demographics
NPI:1881643492
Name:TAYOUN, HITHAM (MD)
Entity type:Individual
Prefix:DR
First Name:HITHAM
Middle Name:
Last Name:TAYOUN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:SAM
Other - Middle Name:
Other - Last Name:MICHAELS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:215 N LOOP 1604 E
Mailing Address - Street 2:# 9305
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78232-1276
Mailing Address - Country:US
Mailing Address - Phone:210-485-8382
Mailing Address - Fax:
Practice Address - Street 1:11503 NW MILITARY HWY STE 106
Practice Address - Street 2:# 44
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78231-1896
Practice Address - Country:US
Practice Address - Phone:210-485-8382
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-09
Last Update Date:2014-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME92630207ZC0500X, 207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZC0500XAllopathic & Osteopathic PhysiciansPathologyCytopathology
No207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXU4467LMedicare PIN
FLU4467AMedicare UPIN
FLI27328Medicare PIN
TXU4467LMedicare PIN