Individual
DR. MAZEN SHUKRI GANIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
18450 HIGHWAY 59 N, HUMBLE, TX 77338-4404
(281) 446-6656
(281) 446-6657
Mailing address
18450 HIGHWAY 59 N, HUMBLE, TX 77338-4404
(281) 446-6566
(281) 446-6657
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
J3699
TX
207RI0011X
Interventional Cardiology Physician
Primary
J3699
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
096790301
—
TX
05
—
1740398577
—
TX
Enumeration date
08/29/2006
Last updated
01/29/2024
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