Provider Demographics
NPI:1386984151
Name:SE,COM,SA
Entity type:Organization
Organization Name:SE,COM,SA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:19050
Authorized Official - Prefix:MS
Authorized Official - First Name:ALI
Authorized Official - Middle Name:AHMAD
Authorized Official - Last Name:AL SSAGOOR
Authorized Official - Suffix:I
Authorized Official - Credentials:MD
Authorized Official - Phone:0096654-345-8682
Mailing Address - Street 1:EUROVILLAGE COMPOUND, AL KHOBAR, EASTERN PROVINCE, 3193
Mailing Address - Street 2:
Mailing Address - City:SAUDI ARABIA
Mailing Address - State:EUROVILLAGE COMPOUND, AL KHOBAR, EASTERN
Mailing Address - Zip Code:19050
Mailing Address - Country:SA
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:EUROVILLAGE COMPOUND, AL KHOBAR, EASTERN PROVINCE, 3193
Practice Address - Street 2:
Practice Address - City:SAUDI ARABIA
Practice Address - State:EUROVILLAGE COMPOUND, AL KHOBAR, EASTERN
Practice Address - Zip Code:19050
Practice Address - Country:SA
Practice Address - Phone:009667-542-4588
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SEC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-02-15
Last Update Date:2013-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1036234605281P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes281P00000XHospitalsChronic Disease Hospital