Provider Demographics
NPI:1912945551
Name:HOMSI, OMAR (MD)
Entity Type:Individual
Prefix:DR
First Name:OMAR
Middle Name:
Last Name:HOMSI
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 1:4102 S CLEAR CREEK RD
Mailing Address - Street 2:STE 107
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76549-5953
Mailing Address - Country:US
Mailing Address - Phone:254-526-8300
Mailing Address - Fax:254-526-4828
Practice Address - Street 1:4102 S CLEAR CREEK RD
Practice Address - Street 2:STE 107
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76549-5953
Practice Address - Country:US
Practice Address - Phone:254-526-8300
Practice Address - Fax:254-526-4828
Is Sole Proprietor?:No
Enumeration Date:2006-06-04
Last Update Date:2013-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK3752174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX092467201Medicaid
TXD87069Medicare UPIN