Provider Demographics
NPI:1952498826
Name:HABASH, AMEEN (MD)
Entity Type:Individual
Prefix:DR
First Name:AMEEN
Middle Name:
Last Name:HABASH
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:PO BOX 190922
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75219-0922
Mailing Address - Country:US
Mailing Address - Phone:817-416-9980
Mailing Address - Fax:817-481-9901
Practice Address - Street 1:1100 E SOUTHLAKE BLVD STE 250
Practice Address - Street 2:
Practice Address - City:SOUTHLAKE
Practice Address - State:TX
Practice Address - Zip Code:76092-6350
Practice Address - Country:US
Practice Address - Phone:817-484-0222
Practice Address - Fax:817-484-0223
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2023-02-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXP1459208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery