Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | S1417 | TX |
NPI | 1003278417 |
---|---|
Provider Name | Ali Abdulsattar Hussein |
First Address | Dallas, TX 75284-0020 |
Second Address | Amarillo, TX 79106-1701 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/03/2016 |
Last Update Date | 07/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1O6827 | MEDICARE (01) | TX |
403408403 | (05) | TX |