Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | BP10056520 | TX |
N | 111NI0900X | Internist | BP10056520 | TX |
Y | 2084N0400X | Neurologist | BP10056520 | TX |
NPI | 1003268889 |
---|---|
Provider Name | Diaa Hamouda |
First Address | Galveston, TX 77555-0539 |
Second Address | Galveston, TX 77555-0539 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/07/2016 |
Last Update Date | 19/04/2017 |