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General NPI Number Information
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NPI Number | 1194779892
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Entity Type | Individual
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Provider Name | HATEM AHMED NOUR EL DEEN MD
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Gender | Male
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Dates
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Enumeration Date | 05/19/2006
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Last Update Date | 07/14/2025
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Provider Practice Location Address
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Address Line | 3101 S AUSTIN AVE
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City | GEORGETOWN
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State | TX
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Zip | 78626-7541
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Country | US
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Telephone | 512-666-4480
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Fax |
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Provider Business Mailing Address
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Address Line | 1605 GEORGE DIETER DR STE 636
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City | EL PASO
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State | TX
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Zip | 79936-5692
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Country | US
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Telephone | 512-666-4480
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | N3212
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License Number State | TX
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