Provider Demographics
NPI:1033320783
Name:ABO KAYASS, AHMAD (MD)
Entity Type:Individual
Prefix:
First Name:AHMAD
Middle Name:
Last Name:ABO KAYASS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1650 REPUBLIC PKWY
Mailing Address - Street 2:STE 120
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75150-6916
Mailing Address - Country:US
Mailing Address - Phone:214-717-9040
Mailing Address - Fax:972-526-5892
Practice Address - Street 1:1650 REPUBLIC PKWY
Practice Address - Street 2:STE 120
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75150-6916
Practice Address - Country:US
Practice Address - Phone:972-285-0838
Practice Address - Fax:972-285-0848
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-24
Last Update Date:2021-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM97682080S0012X
LAMD.201701208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080S0012XAllopathic & Osteopathic PhysiciansPediatricsSleep Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics