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General NPI Number Information
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NPI Number | 1821175621
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Entity Type | Individual
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Provider Name | MAHDI SALEH AL-BASSAM M.D.
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Gender | Male
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 01/31/2017
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Provider Practice Location Address
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Address Line | 7600 BEECHNUT ST
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City | HOUSTON
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State | TX
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Zip | 77074-4302
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Country | US
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Telephone | 281-701-4630
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Fax |
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Provider Business Mailing Address
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Address Line | 17206 KINNEAR RD. N.E.
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City | BAINBRIDGE ISLAND
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State | WA
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Zip | 98110-3022
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Country | US
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Telephone | 281-701-4630
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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 | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number | E0779
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | E0779
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | E0779
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License Number State | TX
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