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NPI Code Detail

MEDICARE: NDA EHOUMAN

MEDICARE: NDA EHOUMAN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163WC0200XCritical Care Medicine Registered Nurse958787TX

General Provider Information

NPI Number : 1053244541
Entity Type Code : Individual
Provider Name (Legal Business Name) : NDA EHOUMAN
Provider Business Mailing Address
First Line : 422 HIDEAWAY LN E
Second Line :
City : HIDEAWAY
State : TX
Zip : 75771-5215
Country : US
Telephone Number : 972-704-4878
Fax Number :
Provider Business Practice Location Address
First Line : 800 E DAWSON ST
Second Line :
City : TYLER
State : TX
Zip : 75701-2036
Country : US
Telephone Number : 903-593-8441
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/04/2026
Last Update Date : 06/04/2026

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Directions to “ NDA EHOUMAN ” Practice Location

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