Provider Demographics
NPI:1114221090
Name:HIGHLANDS MEDICAL ASSOCIATES, P.A.
Entity Type:Organization
Organization Name:HIGHLANDS MEDICAL ASSOCIATES, P.A.
Other - Org Name:DALLAL ABDELSAYED, M.D.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PHYSICIAN/DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DALLAL
Authorized Official - Middle Name:
Authorized Official - Last Name:ABDELSAYED
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-426-8586
Mailing Address - Street 1:607 E WALLISVILLE RD
Mailing Address - Street 2:
Mailing Address - City:HIGHLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77562-3831
Mailing Address - Country:US
Mailing Address - Phone:281-426-8586
Mailing Address - Fax:281-426-7983
Practice Address - Street 1:607 E WALLISVILLE RD
Practice Address - Street 2:
Practice Address - City:HIGHLANDS
Practice Address - State:TX
Practice Address - Zip Code:77562-3831
Practice Address - Country:US
Practice Address - Phone:281-426-8586
Practice Address - Fax:281-426-7983
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-06
Last Update Date:2022-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
4388704OtherAETNA PROVIDER NUMBER
TX121191402Medicaid
TXB20751Medicare UPIN
TX121191402Medicaid