Provider Demographics
NPI:1124240890
Name:ALSABBAGH, MOURAD MOUSA (MD)
Entity type:Individual
Prefix:
First Name:MOURAD
Middle Name:MOUSA
Last Name:ALSABBAGH
Suffix:
Gender:
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:PO BOX 749
Mailing Address - Street 2:
Mailing Address - City:PHARR
Mailing Address - State:TX
Mailing Address - Zip Code:78577-1614
Mailing Address - Country:US
Mailing Address - Phone:956-362-2171
Mailing Address - Fax:956-362-2420
Practice Address - Street 1:1100 E DOVE AVE STE 200
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504-4681
Practice Address - Country:US
Practice Address - Phone:956-362-5433
Practice Address - Fax:956-362-2420
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2025-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP4137204F00000X, 207R00000X, 208M00000X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No204F00000XAllopathic & Osteopathic PhysiciansTransplant Surgery
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX308965802Medicaid
TX450608YNG9Medicare PIN