MEDICARE: DR. GHASSAN AL-HAMMAMI M.D

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
1	2085U0001X	Diagnostic Ultrasound Physician	L0744	TX
2	2085R0202X	Diagnostic Radiology Physician	L0744	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1255344636
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GHASSAN AL-HAMMAMI M.D

Provider Business Mailing Address
First Line	:	2513 W TRENTON RD
Second Line	:
City	:	EDINBURG
State	:	TX
Zip	:	78539-5070
Country	:	US
Telephone Number	:	956-668-9729
Fax Number	:	956-668-9742

Provider Business Practice Location Address
First Line	:	2513 W TRENTON RD
Second Line	:
City	:	EDINBURG
State	:	TX
Zip	:	78539-5070
Country	:	US
Telephone Number	:	956-668-9729
Fax Number	:	956-668-9742

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/15/2006
Last Update Date	:	04/11/2024

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