Individual
DR. BASSEM MORAD MOSTAFA ELSAWY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, CMD, AGSF, FAAFP
Contact information
Practice address
3500 W WHEATLAND RD, DALLAS, TX 75237-3460
(214) 947-5400
(214) 947-5425
Mailing address
3500 W WHEATLAND RD, DALLAS, TX 75237-3460
(214) 947-5400
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
M4379
TX
207QG0300X
Geriatric Medicine (Family Medicine) Physician
M4379
TX
207QH0002X
Hospice and Palliative Medicine (Family Medicine) Physician
M4379
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
156122701
—
TX
05
—
156122702
—
TX
05
—
182868301
—
TX
05
—
200453380
—
IN
01
—
75-2966610
FEIN
TX
Enumeration date
06/04/2006
Last updated
03/14/2022
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