Provider Demographics
NPI:1487183018
Name:HARMOUCHE, JIHAD MOHAMAD
Entity Type:Individual
Prefix:
First Name:JIHAD
Middle Name:MOHAMAD
Last Name:HARMOUCHE
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:PO BOX 58538
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:TX
Mailing Address - Zip Code:77598-8538
Mailing Address - Country:US
Mailing Address - Phone:281-332-3507
Mailing Address - Fax:281-572-8990
Practice Address - Street 1:600 N KOBAYASHI STE 114
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:TX
Practice Address - Zip Code:77598-4841
Practice Address - Country:US
Practice Address - Phone:281-332-3507
Practice Address - Fax:281-572-8990
Is Sole Proprietor?:No
Enumeration Date:2017-06-07
Last Update Date:2023-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXT0086207V00000X, 207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4301113024OtherMICHIGAN EDUCATION LIMITED LICENSE