Provider Demographics
NPI:1447293287
Name:KUSSMAN, HOWARD M (MD)
Entity type:Individual
Prefix:
First Name:HOWARD
Middle Name:M
Last Name:KUSSMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3600 COMMUNICATIONS PKWY
Mailing Address - Street 2:STE 675
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-8162
Mailing Address - Country:US
Mailing Address - Phone:972-599-1637
Mailing Address - Fax:972-599-1631
Practice Address - Street 1:3801 W 15TH ST
Practice Address - Street 2:BLDG A - SUITE 340
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75075-4737
Practice Address - Country:US
Practice Address - Phone:972-599-1637
Practice Address - Fax:972-599-1631
Is Sole Proprietor?:No
Enumeration Date:2006-06-13
Last Update Date:2019-10-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXK3781207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0086EYOtherBC/BS
TX031405602Medicaid
TX8AD946OtherBCBS
TXP00188563Medicare PIN
TX8B2299Medicare PIN