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General NPI Number Information
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NPI Number | 1790273753
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Entity Type | Organization
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Legal Business Name | SOUTHERN ENDOCRINOLOGY ASSOCIATES P.A
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Dates
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Enumeration Date | 04/25/2018
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Last Update Date | 07/05/2018
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Provider Practice Location Address
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Address Line | 1621 N BELT LINE RD STE A
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City | MESQUITE
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State | TX
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Zip | 75149
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Country | US
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Telephone | 972-806-1177
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Fax |
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Provider Business Mailing Address
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Address Line | 1621 N BELT LINE RD STE A
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City | MESQUITE
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State | TX
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Zip | 75149-1795
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Country | US
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Telephone | 972-806-1177
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Fax |
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Authorized Official
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Title or Position | ENDOCRINOLOGIST
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Name | DR. YOUSSEF SHAWKI HASSAN
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Credential | MD
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Telephone | 972-806-1177
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | N4457
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License Number State | TX
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