Healthcare Provider Details

I. General information

NPI: 1861631590
Provider Name (Legal Business Name): OMAR KASS-HOUT M.D., MPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/19/2009
Last Update Date: 10/18/2024
Certification Date: 10/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 N IH 35 STE 610
AUSTIN TX
78705-1850
US

IV. Provider business mailing address

3000 N IH 35 STE 610
AUSTIN TX
78705-1850
US

V. Phone/Fax

Practice location:
  • Phone: 512-681-5050
  • Fax:
Mailing address:
  • Phone: 212-681-5050
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number2017-01736
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number270463
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberQ6855
License Number StateTX
# 4
Primary TaxonomyY
Taxonomy Code2084V0102X
TaxonomyVascular Neurology Physician
License NumberQ6855
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: