Organization
ADVANCED VEIN & VASCULAR ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HUMAM BASSAM KAKISH M.D. (OWNER)
(469) 547-1142
Entity
Organization
Contact information
Practice address
7515 GREENVILLE AVE STE 706, DALLAS, TX 75231-3885
(469) 547-1142
(469) 547-1162
Mailing address
7515 GREENVILLE AVE STE 706, DALLAS, TX 75231-3885
(469) 547-1142
(469) 547-1162
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
K0853
TX
261QM2500X
Medical Specialty Clinic/Center
—
—
Other
Enumeration date
09/07/2010
Last updated
07/24/2024
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