MEDICARE: DR. NAZAR E MOHAMED SANOUSI MD

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	207QG0300X	Geriatric Medicine (Family Medicine) Physician	U6534	TX
2	207Q00000X	Family Medicine Physician	U6534	TX
3	207Q00000X	Family Medicine Physician	15162	NV
4	207QH0002X	Hospice and Palliative Medicine (Family Medicine) Physician	15162	NV
5	207QG0300X	Geriatric Medicine (Family Medicine) Physician	15162	NV

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P01587694	OTHER	NV	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	12682258	OTHER		CAQH
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1215290499
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NAZAR E MOHAMED SANOUSI MD

Provider Business Mailing Address
First Line	:	1155 MILL ST # MCM14
Second Line	:
City	:	RENO
State	:	NV
Zip	:	89502-1576
Country	:	US
Telephone Number	:	775-982-5262
Fax Number	:	775-982-5496

Provider Business Practice Location Address
First Line	:	22698 PROFESSIONAL DR STE 110
Second Line	:
City	:	KINGWOOD
State	:	TX
Zip	:	77339-5705
Country	:	US
Telephone Number	:	281-312-8521
Fax Number	:

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

Provider Enumeration Date	:	06/21/2012
Last Update Date	:	02/23/2026

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Directions to “ DR. NAZAR E MOHAMED SANOUSI MD” Practice Location

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