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NPI Code Detail

MEDICARE: DR. IHSAN HOUSINI M.D.

MEDICARE: DR. IHSAN HOUSINI M.D.
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
1207ZC0500XCytopathology PhysicianH9650TX
2207ZP0102XAnatomic Pathology & Clinical Pathology PhysicianH9650TX

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2220021253OTHERTXRR MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
31184621526OTHERNPI
482P807OTHERTXBCBS

General Provider Information

NPI Number : 1184621526
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. IHSAN HOUSINI M.D.
Provider Business Mailing Address
First Line : 14275 MIDWAY RD
Second Line : SUITE 400
City : ADDISON
State : TX
Zip : 75001-3614
Country : US
Telephone Number :
Fax Number : 610-271-4245
Provider Business Practice Location Address
First Line : 1401 PENNSYLVANIA AVE
Second Line :
City : FORT WORTH
State : TX
Zip : 76104-2113
Country : US
Telephone Number : 713-432-1100
Fax Number : 713-432-0221
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/30/2005
Last Update Date : 09/05/2019

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