Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204F00000X | Transplant Surgeon | P4137 | TX |
Y | 207RN0300X | Nephrologist | P4137 | TX |
NPI | 1124240890 |
---|---|
Provider Name | Mourad Mousa Alsabbagh |
First Address | Pharr, TX 78577-1614 |
Second Address | Mcallen, TX 78504-4681 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/05/2007 |
Last Update Date | 06/04/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
308965802 | (05) | TX |