Basic Information
| Provider Information | |||||||||
| NPI: | 1134587165 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | BASSEM ELSAWY, MD PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 233 BARNES BRIDGE ROAD | ||||||||
| Address2: | |||||||||
| City: | SUNNYVALE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 75182 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4694996110 | ||||||||
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| Practice Location | |||||||||
| Address1: | 419 S COCKTRELL HILL RD | ||||||||
| Address2: | |||||||||
| City: | DUNCANVILLE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 75116 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9727088800 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/04/2016 | ||||||||
| LastUpdateDate: | 06/02/2022 | ||||||||
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| AuthorizedOfficialLastName: | MOSTAFA ELSAWY | ||||||||
| AuthorizedOfficialFirstName: | BASSEM | ||||||||
| AuthorizedOfficialMiddleName: | MORAD | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 4694996110 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
| NPICertificationDate: | 06/02/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207QG0300X | N | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine | Geriatric Medicine | 207RH0002X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Hospice and Palliative Medicine | 207P00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.