Basic Information
| Provider Information | |||||||||
| NPI: | 1477968717 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ABOUELSEOUD | ||||||||
| FirstName: | TANSEEM | ||||||||
| MiddleName: | HAMAD MOHAMED AHMED | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1103 MCMURTRY RIDGE DR | ||||||||
| Address2: | |||||||||
| City: | KATY | ||||||||
| State: | TX | ||||||||
| PostalCode: | 774943965 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3152355416 | ||||||||
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| Practice Location | |||||||||
| Address1: | 4401 GARTH RD | ||||||||
| Address2: | |||||||||
| City: | BAYTOWN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 775212122 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2814208600 | ||||||||
| FaxNumber: | 3157343565 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/25/2014 | ||||||||
| LastUpdateDate: | 11/05/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/05/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | R0171 | TX | N | Allopathic & Osteopathic Physicians | Family Medicine | 208M00000X | R0171 | TX | Y | Allopathic & Osteopathic Physicians | Hospitalist |
ID Information
| ID | Type | State | Issuer | Description | 377155203 | 05 | TX | MEDICAID | 377155204 | 05 | TX | MEDICAID |