Individual
MAMOUN E BASHIR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
701 W. 5TH STREET, DEPARTMENT OF INTERNAL MEDICINE, SUITE 3106, ODESSA, TX 79763
(432) 703-5340
(432) 335-5297
Mailing address
701 W. 5TH STREET, DEPARTMENT OF INTERNAL MEDICINE, SUITE 3106, ODESSA, TX 79763
(432) 703-5340
(432) 335-5297
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
M9147
TX
207RN0300X
Nephrology Physician
Primary
M9147
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1588851232
—
TX
05
—
194080104
—
TX
05
—
194080107
—
TX
Enumeration date
09/26/2007
Last updated
12/23/2025
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