Provider Demographics
NPI:1861631590
Name:KASS-HOUT, OMAR (MD, MPH)
Entity type:Individual
Prefix:
First Name:OMAR
Middle Name:
Last Name:KASS-HOUT
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3000 N IH 35 STE 610
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78705-1850
Mailing Address - Country:US
Mailing Address - Phone:212-681-5050
Mailing Address - Fax:
Practice Address - Street 1:3000 N IH 35 STE 610
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78705-1850
Practice Address - Country:US
Practice Address - Phone:512-681-5050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-02-19
Last Update Date:2024-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2017-017362084N0400X
NY2704632084N0400X
TXQ68552084N0400X, 2084V0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084V0102XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyVascular Neurology
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03778383Medicaid
NY03778383Medicaid