Provider Demographics
NPI:1982089884
Name:ALDAGHSH, SALAMEH (YES)
Entity Type:Individual
Prefix:MR
First Name:SALAMEH
Middle Name:
Last Name:ALDAGHSH
Suffix:
Gender:M
Credentials:YES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11911 GREENVILLE AVE
Mailing Address - Street 2:APT#4203
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75243-3646
Mailing Address - Country:US
Mailing Address - Phone:972-489-5113
Mailing Address - Fax:214-575-7873
Practice Address - Street 1:11911 GREENVILLE AVE
Practice Address - Street 2:APT#4203
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243-3646
Practice Address - Country:US
Practice Address - Phone:972-489-5113
Practice Address - Fax:214-575-7873
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-21
Last Update Date:2015-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX343900000X-NON-EMER343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)