Provider Demographics
NPI:1497110621
Name:AWADA, BAHAA
Entity Type:Individual
Prefix:
First Name:BAHAA
Middle Name:
Last Name:AWADA
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 1:5721 GULFTON ST
Mailing Address - Street 2:# 2501
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77081-2692
Mailing Address - Country:US
Mailing Address - Phone:281-975-7676
Mailing Address - Fax:
Practice Address - Street 1:6624 FANNIN ST
Practice Address - Street 2:# 1630
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2312
Practice Address - Country:US
Practice Address - Phone:713-796-1221
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-14
Last Update Date:2015-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP127716363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health