Osama Aboul-Fettouh, M.D.
Individual provider Active NPI Anesthesiology Physician · Dallas, TX
NPI 1376634741 · NPPES record last updated Oct 27, 2021
Key facts
- NPI
- 1376634741
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Anesthesiology Physician 207L00000X
- License
- M6994 (TX)
- Practice address
- 1935 Medical District Dr
Department of Anesthesiology
Dallas, TX 75235-7701 - Phone
- (214) 456-6393
- Fax
- (214) 456-7232
- NPI assigned
- Sep 28, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 4
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Anesthesiology
- Education
- Other, 1981
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Dallas Physician Medical Services for Children Inc
Practice addresses (Care Compare)
1935 Medical District Dr
Dallas, TX 75235-7701
Phone (214) 456-9250
Hospital & facility affiliations
- Childrens Medical Ctr of Dallas
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20081211000358 | TX | Practitioner - Anesthesiology | 7911930870 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| M6994 | TX | MD | Pediatric Anesthesiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dallas Physician Medical Services for Children Inc | Current |
Accepting new patients | |
| Dallas Physician Medical Services for Children Inc | Anesthesiology | Current |
Accepting new patients |
| Complex Care Medical Services Corporation | Past | Accepting new patients | |
| University Anesthesia Services, PLLC | Anesthesiology | Past | Accepting new patients |
Locations
1935 Medical District Dr
Unit A
Dallas, TX 75235
1935 Medical District Dr
#411
Dallas, TX 75235
1935 Medical District Dr
Dallas, TX 75235
Phone (214) 456-2735
7601 Preston Rd
Plano, TX 75024
Phone (469) 303-7300
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | M6994 | TX | Yes |
| Pediatric Anesthesiology Physician | 207LP3000X | M6994 | TX |
Addresses
Primary practice location
1935 Medical District Dr
Department of Anesthesiology
Dallas, TX 75235-7701
Mailing address
1935 Medical District Dr
Department of Anesthesiology
Dallas, TX 75235-7701
Phone (214) 456-6393
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2010977 01 | Medicaid | TX | |
| 07935714 | Medicaid | MS |
Other names
- Osama A. Fettouh
Other providers in Dallas, TX
- Samer Abou Zeid
- Lana Omar Abou-Khamis
- Layal Kamal Abou-Khamis
- Fadi Aboud Syriani
- Omar Mohammad Aboudawoud
- Abounding Prosperity Incorporated
- Carol Abousaab
- Aus Aboushaer
- Mitchell Albert Aboussie Jr.
- Above All Professional Holdings LLC
All providers in Dallas, TX · Anesthesiology Physician in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 27, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.