Provider Demographics
NPI:1588807275
Name:KANAAN, HAZEM BASSAM (DO)
Entity Type:Individual
Prefix:
First Name:HAZEM
Middle Name:BASSAM
Last Name:KANAAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 E DOVE AVE STE H
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-2263
Mailing Address - Country:US
Mailing Address - Phone:956-843-0173
Mailing Address - Fax:
Practice Address - Street 1:800 E DOVE AVE STE H
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504-2263
Practice Address - Country:US
Practice Address - Phone:956-843-0173
Practice Address - Fax:956-843-0176
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-12
Last Update Date:2020-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP6193207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology