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NPI Code Detail

MEDICARE: REBHI A AWAD MD

MEDICARE: REBHI A AWAD MD
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
12085R0202XDiagnostic Radiology PhysicianJ0431TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2P00059285OTHERTXRRMA

General Provider Information

NPI Number : 1497711535
Entity Type Code : Individual
Provider Name (Legal Business Name) : REBHI A AWAD MD
Provider Business Mailing Address
First Line : 4777 US HIGHWAY 259
Second Line :
City : LONGVIEW
State : TX
Zip : 75605-7668
Country : US
Telephone Number : 903-663-4800
Fax Number : 903-663-7394
Provider Business Practice Location Address
First Line : 1011 N GALLOWAY AVE
Second Line :
City : MESQUITE
State : TX
Zip : 75149-2433
Country : US
Telephone Number : 214-320-7008
Fax Number : 972-480-9024
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/26/2006
Last Update Date : 12/13/2011

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Directions to “ REBHI A AWAD MD” Practice Location

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