Healthcare Provider Details

I. General information

NPI: 1831208461
Provider Name (Legal Business Name): ASH M DABBOUS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/29/2006
Last Update Date: 01/22/2025
Certification Date: 01/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1139 E SONTERRA BLVD SUITE 205
SAN ANTONIO TX
78258
US

IV. Provider business mailing address

PO BOX 1976
SAN ANTONIO TX
78297-1976
US

V. Phone/Fax

Practice location:
  • Phone: 210-614-2229
  • Fax: 210-614-2232
Mailing address:
  • Phone: 210-614-7744
  • Fax: 210-614-2232

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VF0040X
TaxonomyUrogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
License NumberK2324
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberK2324
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: