MEDICARE: MAZEN ALMOUSSA

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	246ZC0007X	Surgical Assistant	4615	TX

General Provider Information

NPI Number	:	1629523139
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MAZEN ALMOUSSA

Provider Business Mailing Address
First Line	:	8407 COOKWIND DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77072-4812
Country	:	US
Telephone Number	:	832-908-2028
Fax Number	:

Provider Business Practice Location Address
First Line	:	8407 COOKWIND DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77072-4812
Country	:	US
Telephone Number	:	832-908-2028
Fax Number	:

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

Provider Enumeration Date	:	08/25/2016
Last Update Date	:	08/25/2016

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Directions to “ MAZEN ALMOUSSA ” Practice Location

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