Provider Demographics
NPI:1689772840
Name:ABU-NASSAR, HANNA J (MD)
Entity Type:Individual
Prefix:DR
First Name:HANNA
Middle Name:J
Last Name:ABU-NASSAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1911 ORCHARD COUNTRY LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77062-2301
Mailing Address - Country:US
Mailing Address - Phone:281-488-1261
Mailing Address - Fax:281-488-0096
Practice Address - Street 1:1911 ORCHARD COUNTRY LN
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77062-2301
Practice Address - Country:US
Practice Address - Phone:281-488-1261
Practice Address - Fax:281-488-0096
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE4162207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP000BB361Medicaid
TXBB36Medicare ID - Type Unspecified
TXP000BB361Medicaid