Provider Demographics
NPI:1114185188
Name:TAREK, NIDALE (MD)
Entity type:Individual
Prefix:DR
First Name:NIDALE
Middle Name:
Last Name:TAREK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7023 NORTHAMPTON WAY
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77055-7622
Mailing Address - Country:US
Mailing Address - Phone:781-752-5978
Mailing Address - Fax:
Practice Address - Street 1:7023 NORTHAMPTON WAY
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77055-7622
Practice Address - Country:US
Practice Address - Phone:781-752-5978
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-27
Last Update Date:2012-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN97822080P0207X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0207XAllopathic & Osteopathic PhysiciansPediatricsPediatric Hematology-Oncology