Provider Demographics
NPI:1477805919
Name:ISBITAN, AHMAD ABBAD (MD)
Entity Type:Individual
Prefix:
First Name:AHMAD
Middle Name:ABBAD
Last Name:ISBITAN
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 1:18220 STATE HIGHWAY 249 STE 205
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77070-4347
Mailing Address - Country:US
Mailing Address - Phone:832-241-2001
Mailing Address - Fax:281-547-7464
Practice Address - Street 1:18220 STATE HIGHWAY 249 STE 205
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-4347
Practice Address - Country:US
Practice Address - Phone:833-241-2001
Practice Address - Fax:281-547-7464
Is Sole Proprietor?:No
Enumeration Date:2012-10-08
Last Update Date:2022-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY48655207RI0011X, 207RC0000X
TXT5927207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY48655OtherKY MEDICAL LICENSE
TXT5927OtherTX MEDICAL LICENSE
KY7100414090Medicaid