Provider Demographics
NPI:1235116393
Name:ELHALWAGI, BAHER M (MD)
Entity type:Individual
Prefix:DR
First Name:BAHER
Middle Name:M
Last Name:ELHALWAGI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:703 E MARSHALL AVE
Mailing Address - Street 2:STE 3008
Mailing Address - City:LONGVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:75601-5500
Mailing Address - Country:US
Mailing Address - Phone:903-315-2740
Mailing Address - Fax:903-315-2742
Practice Address - Street 1:703 E MARSHALL AVE STE 3008
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:TX
Practice Address - Zip Code:75601-5500
Practice Address - Country:US
Practice Address - Phone:903-315-2740
Practice Address - Fax:903-315-2742
Is Sole Proprietor?:No
Enumeration Date:2005-12-29
Last Update Date:2022-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK2456207RS0012X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX122034502Medicaid