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General NPI Number Information
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NPI Number | 1225690654
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Entity Type | Individual
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Provider Name | ABDUSSALAM ELSENOUSI ELSENOUSI MD
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Gender | Male
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Dates
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Enumeration Date | 07/06/2019
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Last Update Date | 05/10/2021
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Provider Practice Location Address
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Address Line | 6720 BERTNER AVE
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City | HOUSTON
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State | TX
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Zip | 77030-2604
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Country | US
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Telephone | 713-851-2803
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Fax |
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Provider Business Mailing Address
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Address Line | 6770 BERTNER AVE STE C355K
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City | HOUSTON
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State | TX
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Zip | 77030-2604
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Country | US
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Telephone | 832-355-3000
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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 | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number | BP30069429
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number | S4463
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License Number State | TX
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