Provider Demographics
NPI:1912126913
Name:KASEB, ENAS H (MD)
Entity Type:Individual
Prefix:DR
First Name:ENAS
Middle Name:H
Last Name:KASEB
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3569 BUSINESS CENTER DR STE 160
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-1914
Mailing Address - Country:US
Mailing Address - Phone:248-910-3092
Mailing Address - Fax:
Practice Address - Street 1:3569 BUSINESS CENTER DR STE 160
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-1914
Practice Address - Country:US
Practice Address - Phone:855-877-5977
Practice Address - Fax:832-603-4755
Is Sole Proprietor?:No
Enumeration Date:2007-04-25
Last Update Date:2022-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301082355207Q00000X
TXM9397207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
8AN554OtherBCBSTX
TX8L2447Medicare PIN