Provider Demographics
NPI:1477968717
Name:ABOUELSEOUD, TANSEEM HAMAD MOHAMED AHMED (MD)
Entity Type:Individual
Prefix:
First Name:TANSEEM
Middle Name:HAMAD MOHAMED AHMED
Last Name:ABOUELSEOUD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1103 MCMURTRY RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-3965
Mailing Address - Country:US
Mailing Address - Phone:315-235-5416
Mailing Address - Fax:
Practice Address - Street 1:4401 GARTH RD
Practice Address - Street 2:
Practice Address - City:BAYTOWN
Practice Address - State:TX
Practice Address - Zip Code:77521-2122
Practice Address - Country:US
Practice Address - Phone:281-420-8600
Practice Address - Fax:315-734-3565
Is Sole Proprietor?:No
Enumeration Date:2014-06-25
Last Update Date:2022-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR0171207Q00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX377155203Medicaid
TX377155204Medicaid