Basic Information
Provider Information
NPI: 1578983839
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ABDELSAYED
FirstName: JOHN
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 13811 MURPHY RD
Address2:  
City: STAFFORD
State: TX
PostalCode: 774774903
CountryCode: US
TelephoneNumber: 7137721200
FaxNumber: 7132556315
Practice Location
Address1: 17510 W GRAND PKWY S STE 490
Address2:  
City: SUGAR LAND
State: TX
PostalCode: 774792649
CountryCode: US
TelephoneNumber: 7137721200
FaxNumber: 2813423957
Other Information
ProviderEnumerationDate: 04/24/2014
LastUpdateDate: 06/14/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 06/14/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
390200000X  N Student, Health CareStudent in an Organized Health Care Education/Training Program 
208600000XS1323TXY Allopathic & Osteopathic PhysiciansSurgery 

No ID Information.


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