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General NPI Number Information
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NPI Number | 1972506228
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Entity Type | Individual
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Provider Name | HERBERT J. NASSOUR III M. D.
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Gender | Male
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Dates
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Enumeration Date | 05/31/2005
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Last Update Date | 12/09/2019
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Provider Practice Location Address
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Address Line | 3804 S JACKSON RD STE 1
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City | EDINBURG
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State | TX
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Zip | 78539-6681
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Country | US
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Telephone | 956-296-3001
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Fax | 956-296-3000
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Provider Business Mailing Address
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Address Line | 2102 TREASURE HILLS BLVD STE 3.14406
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City | HARLINGEN
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State | TX
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Zip | 78550-8736
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Country | US
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Telephone | 956-296-1437
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Fax | 956-296-6842
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | G5975
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 2086S0122X
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Taxonomy Name | Plastic and Reconstructive Surgery Physician
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License Number | G5975
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License Number State | TX
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