Healthcare Provider Details

I. General information

NPI: 1245382209
Provider Name (Legal Business Name): DIYAA MOHAMMAD HASSANEIN NAWAR M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/18/2007
Last Update Date: 07/12/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

HOUSTON COMMUNITY HEALTH CTRS. INC./DENVER HARBOR CLIN 424 HAHLO ST
HOUSTON TX
77020-3022
US

IV. Provider business mailing address

1333 ELDRIDGE PKWY #1432
HOUSTON TX
77077-1610
US

V. Phone/Fax

Practice location:
  • Phone: 713-674-3326
  • Fax:
Mailing address:
  • Phone: 832-248-6876
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberM2515
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME91972
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: