Provider Demographics
NPI:1881866424
Name:OMEIS, IBRAHIM (MD)
Entity Type:Individual
Prefix:DR
First Name:IBRAHIM
Middle Name:
Last Name:OMEIS
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 1:1709 DRYDEN RD STE 750
Mailing Address - Street 2:DEPT. OF NEUROSURGERY
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2418
Mailing Address - Country:US
Mailing Address - Phone:713-798-4696
Mailing Address - Fax:
Practice Address - Street 1:1709 DRYDEN RD STE 750
Practice Address - Street 2:DEPT. OF NEUROSURGERY
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2418
Practice Address - Country:US
Practice Address - Phone:713-798-4696
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-24
Last Update Date:2011-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0065457207T00000X
TXN1810207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP000740461Medicare PIN
TX8L15639Medicare PIN
TX8L16921Medicare PIN