Provider Demographics
NPI:1184861791
Name:HAMMOUDEH, FADI NABIL SALIM (MD)
Entity Type:Individual
Prefix:
First Name:FADI
Middle Name:NABIL SALIM
Last Name:HAMMOUDEH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1429 HIGHWAY 6
Mailing Address - Street 2:SUITE 303
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-5134
Mailing Address - Country:US
Mailing Address - Phone:713-781-4600
Mailing Address - Fax:713-917-5780
Practice Address - Street 1:1429 HIGHWAY 6
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-5134
Practice Address - Country:US
Practice Address - Phone:713-781-4600
Practice Address - Fax:713-917-5780
Is Sole Proprietor?:No
Enumeration Date:2009-01-20
Last Update Date:2016-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA39291207R00000X, 207RP1001X
TXQ8499207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
8FZ111OtherBCBS
IA1184861791Medicaid
8FZ111OtherBCBS
TX506175YN34Medicare PIN