MEDICARE: ABDULLAHI HASSAN DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223S0112X	Oral and Maxillofacial Surgery (Dentist)	36506	TX

General Provider Information

NPI Number	:	1013388107
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ABDULLAHI HASSAN DDS

Provider Business Mailing Address
First Line	:	6560 FANNIN ST STE 1280
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77030-2753
Country	:	US
Telephone Number	:	832-876-9631
Fax Number	:

Provider Business Practice Location Address
First Line	:	6560 FANNIN ST STE 1280
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77030-2753
Country	:	US
Telephone Number	:	832-876-9631
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/14/2015
Last Update Date	:	09/14/2021

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