Provider Demographics
NPI:1700362522
Name:COUSSA, RAZEK GEORGES (MDCM, MPHIL, MENG)
Entity Type:Individual
Prefix:DR
First Name:RAZEK GEORGES
Middle Name:
Last Name:COUSSA
Suffix:
Gender:M
Credentials:MDCM, MPHIL, MENG
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:608 STANTON L YOUNG BLVD
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73104-5065
Mailing Address - Country:US
Mailing Address - Phone:405-271-6060
Mailing Address - Fax:405-271-1926
Practice Address - Street 1:608 STANTON L YOUNG BLVD
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73104-5065
Practice Address - Country:US
Practice Address - Phone:405-271-6060
Practice Address - Fax:405-271-1926
Is Sole Proprietor?:No
Enumeration Date:2018-07-15
Last Update Date:2022-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.132491207W00000X
IAMD-45956207W00000X, 207WX0110X
OK34604207WX0107X
IAND-45956207WX0107X
OK39114207WX0107X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No207WX0110XAllopathic & Osteopathic PhysiciansOphthalmologyPediatric Ophthalmology and Strabismus Specialist