Active NPI
Omar Mohamed Hammouda, PA-C
- Physician Assistant
- Fort Bliss, TX
National Provider Identifier
1780487090
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 1236769
- Practice address
- 11335 SSG Sims St
Fort Bliss, TX 79918-8033 - Phone
- (915) 742-0232
- NPI assigned
- Mar 31, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 1236769 | Primary | |
| Military Health Care Provider | 171000000X | 1236769 | OR |
Addresses
Primary practice location
11335 SSG Sims St
Fort Bliss, TX 79918-8033
Mailing address
18835A 71St Cres
Fresh Meadows, NY 11365-5042
Phone (917) 373-9337
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1236769 | OR | MD | Military Health Care Provider |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1743379200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1767916800000",
"number": "1780487090",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18835A 71ST CRES",
"city": "FRESH MEADOWS",
"state": "NY",
"postal_code": "113655042",
"telephone_number": "917-373-9337"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11335 SSG SIMS ST",
"city": "FORT BLISS",
"state": "TX",
"postal_code": "799188033",
"telephone_number": "915-742-0232"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAMMOUDA",
"first_name": "OMAR",
"middle_name": "MOHAMED",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-03-31",
"last_updated": "2026-01-09",
"certification_date": "2026-01-09",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": null,
"license": "1236769",
"primary": true
},
{
"code": "171000000X",
"taxonomy_group": "",
"desc": "Military Health Care Provider",
"state": "OR",
"license": "1236769",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Bliss, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.