Provider Demographics
NPI:1033590690
Name:ALBREJAWI ALHOMSI, ANAS
Entity Type:Individual
Prefix:
First Name:ANAS
Middle Name:
Last Name:ALBREJAWI ALHOMSI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:ANAS
Other - Middle Name:
Other - Last Name:ALHOMSI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1631 11TH STREET
Mailing Address - Street 2:UNIT B
Mailing Address - City:WICHITA FALLS
Mailing Address - State:TX
Mailing Address - Zip Code:76301-2245
Mailing Address - Country:US
Mailing Address - Phone:940-263-3000
Mailing Address - Fax:940-263-3018
Practice Address - Street 1:1631 11TH STREET
Practice Address - Street 2:UNIT B
Practice Address - City:WICHITA FALLS
Practice Address - State:TX
Practice Address - Zip Code:76301-7630
Practice Address - Country:US
Practice Address - Phone:940-263-3000
Practice Address - Fax:940-263-3018
Is Sole Proprietor?:No
Enumeration Date:2015-06-09
Last Update Date:2022-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR4803207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine