Healthcare Provider Details

I. General information

NPI: 1467747485
Provider Name (Legal Business Name): HASHEM DADOUSH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: HACHEM DADOUCH MD

II. Dates (important events)

Enumeration Date: 06/17/2011
Last Update Date: 06/04/2025
Certification Date: 06/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

314 E HIGHLAND MALL BLVD STE 305
AUSTIN TX
78752-3731
US

IV. Provider business mailing address

314 E HIGHLAND MALL BLVD STE 305
AUSTIN TX
78752-3731
US

V. Phone/Fax

Practice location:
  • Phone: 512-807-0640
  • Fax: 737-242-7961
Mailing address:
  • Phone: 512-807-0640
  • Fax: 737-242-7961

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberN8900
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code2084P0802X
TaxonomyAddiction Psychiatry Physician
License NumberN8900
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberN8900
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: