Provider Demographics
NPI:1093035511
Name:OSMAN, HOUSSAM (MD)
Entity Type:Individual
Prefix:
First Name:HOUSSAM
Middle Name:
Last Name:OSMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:HOSSAM
Other - Middle Name:
Other - Last Name:OSMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 674096
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75267-4096
Mailing Address - Country:US
Mailing Address - Phone:972-616-4011
Mailing Address - Fax:214-272-8985
Practice Address - Street 1:2805 E PRESIDENT GEORGE BUSH HWY
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75082-3561
Practice Address - Country:US
Practice Address - Phone:972-619-3500
Practice Address - Fax:214-272-8985
Is Sole Proprietor?:No
Enumeration Date:2010-06-07
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP58592086X0206X, 208600000X
OH57.013347390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX323051801Medicaid
TX8DS401OtherBCBS
TX8DS401OtherBCBS