Individual
DR. IHSAN HOUSINI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1401 PENNSYLVANIA AVE, FORT WORTH, TX 76104-2113
(713) 432-1100
(713) 432-0221
Mailing address
14275 MIDWAY RD, SUITE 400, ADDISON, TX 75001-3614
(610) 271-4245
Taxonomy
Speciality
Code
Description
License number
State
207ZC0500X
Cytopathology Physician
H9650
TX
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
H9650
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103338301
—
TX
01
—
1184621526
NPI
—
01
—
220021253
RR MEDICARE
TX
01
—
82P807
BCBS
TX
Enumeration date
06/30/2005
Last updated
09/05/2019
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