Provider Demographics
NPI:1215655584
Name:ABDULHUSSEIN, AHMED GWAD
Entity type:Individual
Prefix:
First Name:AHMED
Middle Name:GWAD
Last Name:ABDULHUSSEIN
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 1:1404 LOCHALINE LOOP
Mailing Address - Street 2:
Mailing Address - City:PFLUGERVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78660-1763
Mailing Address - Country:US
Mailing Address - Phone:512-970-8580
Mailing Address - Fax:
Practice Address - Street 1:1404 LOCHALINE LOOP
Practice Address - Street 2:
Practice Address - City:PFLUGERVILLE
Practice Address - State:TX
Practice Address - Zip Code:78660-1763
Practice Address - Country:US
Practice Address - Phone:512-970-8580
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-22
Last Update Date:2022-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)