Provider Demographics
NPI:1245207372
Name:AL-HAKEEM, HOUMAM (MD)
Entity Type:Individual
Prefix:DR
First Name:HOUMAM
Middle Name:
Last Name:AL-HAKEEM
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 1:7430 BARLITE BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78224-1366
Mailing Address - Country:US
Mailing Address - Phone:210-568-1949
Mailing Address - Fax:210-568-8347
Practice Address - Street 1:7430 BARLITE BLVD
Practice Address - Street 2:SUITE 101
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78224-1308
Practice Address - Country:US
Practice Address - Phone:210-568-1949
Practice Address - Fax:210-568-8347
Is Sole Proprietor?:No
Enumeration Date:2006-03-07
Last Update Date:2020-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM2224207V00000X, 207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX175054901Medicaid
0-549-417-4OtherECFMG
0-549-417-4OtherECFMG
TX8F1155Medicare ID - Type UnspecifiedINDIVIDUAL