Individual provider Active NPI

Issam Harmoush, MD

  • Surgery Physician
  • Port Arthur, TX
National Provider Identifier
1346249653
Registry record updated Jul 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
G4230 Issued in TX
Practice address
2501 Jimmy Johnson Blvd
Suite 403
Port Arthur, TX 77640-2000
Phone
(409) 853-5987
Fax
(409) 853-5978
NPI assigned
Jul 19, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 3, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X G4230 TX Primary

Addresses

Primary practice location

2501 Jimmy Johnson Blvd
Suite 403
Port Arthur, TX 77640-2000

Mailing address

2501 Jimmy Johnson Blvd
Suite 403
Port Arthur, TX 77640-2000
Phone (409) 853-5987

Other identifiers 1

IdentifierTypeStateIssuer
099812201MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G4230TXMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hong Catherine Trinh Medica Group LLP PastSince Jul 1, 2004 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1121731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341273600000",
    "number": "1346249653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2501 JIMMY JOHNSON BLVD",
            "address_2": "SUITE 403",
            "city": "PORT ARTHUR",
            "state": "TX",
            "postal_code": "776402000",
            "telephone_number": "409-853-5987",
            "fax_number": "409-853-5978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 JIMMY JOHNSON BLVD",
            "address_2": "SUITE 403",
            "city": "PORT ARTHUR",
            "state": "TX",
            "postal_code": "776402000",
            "telephone_number": "409-853-5987",
            "fax_number": "409-853-5978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARMOUSH",
        "first_name": "ISSAM",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-19",
        "last_updated": "2012-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TX",
            "license": "G4230",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "099812201",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Arthur, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.