Provider Demographics
NPI:1316813280
Name:ABDELWAHAB, TAMIRAN
Entity type:Individual
Prefix:
First Name:TAMIRAN
Middle Name:
Last Name:ABDELWAHAB
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 N TARRANT PKWY APT 225
Mailing Address - Street 2:
Mailing Address - City:KELLER
Mailing Address - State:TX
Mailing Address - Zip Code:76248-5678
Mailing Address - Country:US
Mailing Address - Phone:916-897-1107
Mailing Address - Fax:
Practice Address - Street 1:500 N TARRANT PKWY APT 225
Practice Address - Street 2:
Practice Address - City:KELLER
Practice Address - State:TX
Practice Address - Zip Code:76248-5678
Practice Address - Country:US
Practice Address - Phone:916-897-1107
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-16
Last Update Date:2025-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter