Healthcare Provider Details
I. General information
NPI: 1952763468
Provider Name (Legal Business Name): RIMA GHASSAN DABABNEH M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/23/2016
Last Update Date: 01/18/2024
Certification Date: 01/18/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6410 FANNIN ST STE 370
HOUSTON TX
77030-3004
US
IV. Provider business mailing address
841 PRUDENTIAL DR STE 1130
JACKSONVILLE FL
32207-8331
US
V. Phone/Fax
- Phone: 713-486-6755
- Fax: 713-383-1478
- Phone: 904-633-4199
- Fax: 904-633-4188
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | ME140020 |
| License Number State | FL |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 390200000X |
| Taxonomy | Student in an Organized Health Care Education/Training Program |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2080P0202X |
| Taxonomy | Pediatric Cardiology Physician |
| License Number | U5674 |
| License Number State | TX |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: