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General NPI Number Information
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NPI Number | 1770927253
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Entity Type | Individual
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Provider Name | MOHAMED GINAWI HUSSEIN M.B.B.S., M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/26/2013
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Last Update Date | 11/09/2016
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Provider Practice Location Address
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Address Line | 11801 SOUTH FWY # I35W
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City | BURLESON
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State | TX
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Zip | 76028-7021
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Country | US
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Telephone | 832-314-5541
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Fax |
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Provider Business Mailing Address
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Address Line | 1301 SOLANA BLVD STE 2200
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City | WESTLAKE
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State | TX
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Zip | 76262-1769
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Country | US
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Telephone | 832-314-5541
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | R0589
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License Number State | TX
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