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General NPI Number Information
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NPI Number | 1952498826
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Entity Type | Individual
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Provider Name | AMEEN HABASH M.D.
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Gender | Male
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Dates
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Enumeration Date | 10/10/2006
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Last Update Date | 02/13/2023
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Provider Practice Location Address
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Address Line | 1100 E SOUTHLAKE BLVD STE 250
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City | SOUTHLAKE
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State | TX
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Zip | 76092-6350
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Country | US
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Telephone | 817-484-0222
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Fax | 817-484-0223
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Provider Business Mailing Address
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Address Line | PO BOX 190922
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City | DALLAS
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State | TX
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Zip | 75219-0922
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Country | US
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Telephone | 817-416-9980
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Fax | 817-481-9901
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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 | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | P1459
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License Number State | TX
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