Provider Demographics
NPI:1871585588
Name:GHUSN, HUSAM (MD)
Entity type:Individual
Prefix:
First Name:HUSAM
Middle Name:
Last Name:GHUSN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1211 HIGHWAY 6
Mailing Address - Street 2:SUITE 1
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-4941
Mailing Address - Country:US
Mailing Address - Phone:281-494-4832
Mailing Address - Fax:281-494-7399
Practice Address - Street 1:3803 FM 1092 RD
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77459-2209
Practice Address - Country:US
Practice Address - Phone:281-403-8271
Practice Address - Fax:281-403-8274
Is Sole Proprietor?:No
Enumeration Date:2005-08-18
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036169067207RE0101X
TXH5171207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX137392005Medicaid
TX8435J7Medicare ID - Type Unspecified