Healthcare Provider Details

I. General information

NPI: 1578508313
Provider Name (Legal Business Name): HOWARD M KUSSMAN, MD, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2006
Last Update Date: 07/15/2022
Certification Date: 07/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3600 COMMUNICATIONS PKWY STE 675
PLANO TX
75093-8162
US

IV. Provider business mailing address

3600 COMMUNICATIONS PKWY STE 675
PLANO TX
75093-8162
US

V. Phone/Fax

Practice location:
  • Phone: 214-518-8206
  • Fax: 469-200-4815
Mailing address:
  • Phone: 214-518-8206
  • Fax: 469-200-4815

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: HOWARD M KUSSMAN
Title or Position: OWNER
Credential: MD
Phone: 214-518-8206