=====================================================
General NPI Number Information
=====================================================
NPI Number | 1902082969
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HAMMAMI IMAGING & ASSOCIATES MD PA
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/21/2008
-----------------------------------------------------
Last Update Date | 04/11/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2513 W. TRENTON RD
-----------------------------------------------------
City | EDINBURG
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78539-5070
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 956-668-9729
-----------------------------------------------------
Fax | 956-668-9742
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2513 W. TRENTON RD
-----------------------------------------------------
City | EDINBURG
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78539-5070
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 956-668-9729
-----------------------------------------------------
Fax | 956-668-9742
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/MD
-----------------------------------------------------
Name | GHASSAN AL-HAMMAMI
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 956-668-9729
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2085R0202X
-----------------------------------------------------
Taxonomy Name | Diagnostic Radiology Physician
-----------------------------------------------------
License Number | L0744
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------