Provider Demographics
NPI:1124460944
Name:TAREQ HULALI, M.D., LP
Entity type:Organization
Organization Name:TAREQ HULALI, M.D., LP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:TAREQ
Authorized Official - Middle Name:
Authorized Official - Last Name:HULALI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:251-533-7766
Mailing Address - Street 1:5317 GREATHOUSE AVE
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79707-3133
Mailing Address - Country:US
Mailing Address - Phone:432-242-0540
Mailing Address - Fax:432-242-0541
Practice Address - Street 1:3421 CALDERA BLVD
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79707-2825
Practice Address - Country:US
Practice Address - Phone:432-242-0540
Practice Address - Fax:432-242-0541
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-22
Last Update Date:2013-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN3740208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty