Provider Demographics
NPI:1003268889
Name:HAMOUDA, DIAA (MBBCH)
Entity Type:Individual
Prefix:
First Name:DIAA
Middle Name:
Last Name:HAMOUDA
Suffix:
Gender:M
Credentials:MBBCH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 UNIVERSITY BLVD
Mailing Address - Street 2:JSA 9.128
Mailing Address - City:GALVESTON
Mailing Address - State:TX
Mailing Address - Zip Code:77555-0539
Mailing Address - Country:US
Mailing Address - Phone:409-772-8031
Mailing Address - Fax:409-772-6940
Practice Address - Street 1:301 UNIVERSITY BLVD
Practice Address - Street 2:JSA 9.128
Practice Address - City:GALVESTON
Practice Address - State:TX
Practice Address - Zip Code:77555-0539
Practice Address - Country:US
Practice Address - Phone:409-772-8031
Practice Address - Fax:409-772-6940
Is Sole Proprietor?:No
Enumeration Date:2016-07-06
Last Update Date:2017-04-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXBP10056520207R00000X, 2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine