Provider Demographics
NPI:1457840654
Name:ABOU-AWAD, MOUSA
Entity Type:Individual
Prefix:
First Name:MOUSA
Middle Name:
Last Name:ABOU-AWAD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16100 CAIRNWAY DR STE 266
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77084-3597
Mailing Address - Country:US
Mailing Address - Phone:832-998-7459
Mailing Address - Fax:
Practice Address - Street 1:16100 CAIRNWAY DR STE 266
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77084-3597
Practice Address - Country:US
Practice Address - Phone:832-998-7459
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-03
Last Update Date:2018-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant