Provider Demographics
NPI:1063624302
Name:HANNA, EHAB IBRAHIM (MD)
Entity type:Individual
Prefix:DR
First Name:EHAB
Middle Name:IBRAHIM
Last Name:HANNA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:EHAB
Other - Middle Name:EBRAHIM
Other - Last Name:ABDELSAYED
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:921 E FM 1187
Mailing Address - Street 2:SUITE A
Mailing Address - City:CROWLEY
Mailing Address - State:TX
Mailing Address - Zip Code:76036-4363
Mailing Address - Country:US
Mailing Address - Phone:817-945-1682
Mailing Address - Fax:817-945-1686
Practice Address - Street 1:921 E FM 1187 STE A
Practice Address - Street 2:
Practice Address - City:CROWLEY
Practice Address - State:TX
Practice Address - Zip Code:76036-4364
Practice Address - Country:US
Practice Address - Phone:817-945-1682
Practice Address - Fax:817-945-1686
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-07
Last Update Date:2019-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN1245207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine