Provider Demographics
NPI:1073952479
Name:ALDUJAILI, AYMEN ABBAS HASAN (MD)
Entity Type:Individual
Prefix:DR
First Name:AYMEN
Middle Name:ABBAS HASAN
Last Name:ALDUJAILI
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:450 THIS WAY ST STE B
Mailing Address - Street 2:
Mailing Address - City:LAKE JACKSON
Mailing Address - State:TX
Mailing Address - Zip Code:77566-5152
Mailing Address - Country:US
Mailing Address - Phone:979-297-2220
Mailing Address - Fax:979-297-3330
Practice Address - Street 1:7777 SOUTHWEST FWY STE 1052
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-1813
Practice Address - Country:US
Practice Address - Phone:979-299-0091
Practice Address - Fax:979-285-9430
Is Sole Proprietor?:No
Enumeration Date:2013-06-19
Last Update Date:2021-07-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXR6141207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX389021202Medicaid