Individual
ANDRE MICHEL ILBAWI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1515 HOLCOMBE BLVD, HOUSTON, TX 77030-4009
(713) 792-6161
Mailing address
PO BOX 4439, HOUSTON, TX 77210-4439
(713) 792-2991
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
ML60020733
WA
2086X0206X
Surgical Oncology Physician
Primary
P5820
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
320203801 (MDACC)
—
TX
01
—
8DT083
BCBS (MDACC)
TX
Enumeration date
08/19/2008
Last updated
10/28/2013
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