# ADVANCED VEIN & VASCULAR ASSOCIATES

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1497062830
- **Authorized official:** DR. HUMAM BASSAM KAKISH M.D. (OWNER)
- **Authorized official phone:** (469) 547-1142

## Contact information

- **Practice address:** 7515 GREENVILLE AVE STE 706, DALLAS, TX 75231-3885
- **Practice address phone:** (469) 547-1142
- **Practice address fax:** (469) 547-1162
- **Mailing address:** 7515 GREENVILLE AVE STE 706, DALLAS, TX 75231-3885
- **Mailing address phone:** (469) 547-1142
- **Mailing address fax:** (469) 547-1162

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2086S0129X | Vascular Surgery Physician | K0853 | TX | Yes |
| 261QM2500X | Medical Specialty Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 09/07/2010
- **Last updated:** 07/24/2024