Provider Demographics
NPI:1467747485
Name:DADOUSH, HASHEM (MD)
Entity Type:Individual
Prefix:
First Name:HASHEM
Middle Name:
Last Name:DADOUSH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:HACHEM
Other - Middle Name:
Other - Last Name:DADOUCH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:503 W 41ST STREET
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78751-4510
Mailing Address - Country:US
Mailing Address - Phone:512-551-8545
Mailing Address - Fax:844-300-6524
Practice Address - Street 1:503 W 41ST STREET
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78751-4510
Practice Address - Country:US
Practice Address - Phone:512-551-8545
Practice Address - Fax:844-300-6524
Is Sole Proprietor?:No
Enumeration Date:2011-06-17
Last Update Date:2021-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN8900207R00000X, 2084P0802X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No2084P0802XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
276215YMW4OtherMEDICARE PTAN