Provider Demographics
NPI:1134587165
Name:BASSEM ELSAWY, MD PA
Entity type:Organization
Organization Name:BASSEM ELSAWY, MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BASSEM
Authorized Official - Middle Name:MORAD
Authorized Official - Last Name:MOSTAFA ELSAWY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:469-499-6110
Mailing Address - Street 1:233 BARNES BRIDGE ROAD
Mailing Address - Street 2:
Mailing Address - City:SUNNYVALE
Mailing Address - State:TX
Mailing Address - Zip Code:75182
Mailing Address - Country:US
Mailing Address - Phone:469-499-6110
Mailing Address - Fax:
Practice Address - Street 1:419 S COCKTRELL HILL RD
Practice Address - Street 2:
Practice Address - City:DUNCANVILLE
Practice Address - State:TX
Practice Address - Zip Code:75116
Practice Address - Country:US
Practice Address - Phone:972-708-8800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-04
Last Update Date:2022-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
No207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric MedicineGroup - Single Specialty
No207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative MedicineGroup - Multi-Specialty