Provider Demographics
NPI:1194436147
Name:ALDABE, OMAR MAHMOUD
Entity type:Individual
Prefix:
First Name:OMAR
Middle Name:MAHMOUD
Last Name:ALDABE
Suffix:
Gender:M
Credentials:
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 760189
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78245-0189
Mailing Address - Country:US
Mailing Address - Phone:832-810-9012
Mailing Address - Fax:832-810-9013
Practice Address - Street 1:11803 WESTHEIMER RD STE 720
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77077-6796
Practice Address - Country:US
Practice Address - Phone:832-810-9012
Practice Address - Fax:832-810-9013
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-12
Last Update Date:2025-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1110399363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health