Provider Demographics
NPI:1659807113
Name:DESSALEGN, METTY
Entity type:Individual
Prefix:
First Name:METTY
Middle Name:
Last Name:DESSALEGN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12141 RICHMOND AVE
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77082-2408
Mailing Address - Country:US
Mailing Address - Phone:281-558-3444
Mailing Address - Fax:
Practice Address - Street 1:12141 RICHMOND AVE
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77082-2408
Practice Address - Country:US
Practice Address - Phone:281-558-3444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-03
Last Update Date:2025-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXU6468207R00000X
OK35411207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine