1770927253 NPI number — DR. MOHAMED GINAWI HUSSEIN M.B.B.S., M.D.

Table of content: DR. MOHAMED GINAWI HUSSEIN M.B.B.S., M.D. (NPI 1770927253)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1770927253 NPI number — DR. MOHAMED GINAWI HUSSEIN M.B.B.S., M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HUSSEIN
Provider First Name:
MOHAMED
Provider Middle Name:
GINAWI
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.B.B.S., M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1770927253
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/09/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1301 SOLANA BLVD STE 2200
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WESTLAKE
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
76262-1769
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
832-314-5541
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
11801 SOUTH FWY # I35W
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BURLESON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
76028-7021
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
832-314-5541
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/26/2013

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  R0589 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)