Provider Demographics
NPI:1841655800
Name:QAMHIEH, HANI (CSFA)
Entity type:Individual
Prefix:
First Name:HANI
Middle Name:
Last Name:QAMHIEH
Suffix:
Gender:M
Credentials:CSFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1413 GINN WAY
Mailing Address - Street 2:
Mailing Address - City:LUFKIN
Mailing Address - State:TX
Mailing Address - Zip Code:75901-6037
Mailing Address - Country:US
Mailing Address - Phone:214-326-3775
Mailing Address - Fax:
Practice Address - Street 1:1413 GINN WAY
Practice Address - Street 2:
Practice Address - City:LUFKIN
Practice Address - State:TX
Practice Address - Zip Code:75901-6037
Practice Address - Country:US
Practice Address - Phone:214-326-3775
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-17
Last Update Date:2015-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX155166363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical