Provider Demographics
NPI:1114937885
Name:SABBAGH, MOUIN F (MD)
Entity Type:Individual
Prefix:DR
First Name:MOUIN
Middle Name:F
Last Name:SABBAGH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3027 PELICAN CV
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-7639
Mailing Address - Country:US
Mailing Address - Phone:979-235-0088
Mailing Address - Fax:
Practice Address - Street 1:4200 TWELVE OAKS DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77027-6812
Practice Address - Country:US
Practice Address - Phone:713-795-4884
Practice Address - Fax:713-383-4446
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-08
Last Update Date:2023-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ6229207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX096698802Medicaid
TX01867596Medicaid
TXN1114937885OtherUNITED AMERICAN
00891736OtherBCBS HIGHMARK
TX761240778OtherBLUE CROSS BLUE SHIELD OF TEXAS
TXMOUINF38098OtherOPTUM
TX01867596Medicaid
TX761240778OtherBCBS OF TEXAS
TXTXP46522OtherCHANGEHEALTHCARE
TX000891736OtherBCBS ANTHEM
TX110091516OtherRAILROAD PART B MEDICARE
TX3318205OtherBLUE LINK
TXJ6229OtherMEDICAL LICENSE
TX096698802Medicaid
5300513OtherAETNA TPA
TX9638254550OtherPECOS UID
136330602OtherCIGNA
TX0004-0015904OtherCARE IMPROVEMENT PLUS
TX10609663OtherCAQH
TX1659212OtherWELLCARE/SELECTCARE OF TEXAS
TX1659212OtherWELLCARE/SELECTCARE OF TEXAS