Husam Srour Mallah, MD

Primary specialty

Pediatric Gastroenterology PhysicianTaxonomy code 2080P0206X

License

50552 Issued in AZ

Practice address

5310 W Thunderbird Rd Ste W311
Glendale, AZ 85306-4706

Phone

(602) 865-4230

Fax

(602) 865-4250

NPI assigned

Feb 12, 2007

Last updated

Jan 1, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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

• Banner Physician Super Specialists Arizona LLC

  • Multi-Specialty Clinic/Center
  • Phoenix, AZ
  • NPI 1841573870
  Medicare reassignment NPD
• Banner-University Medical Group

  • Multi-Specialty Clinic/Center
  • Phoenix, AZ
  • NPI 1508809427

  Family Medicine

  Medicare reassignment NPD
• Banner Physician Super Specialists Arizona LLC

  • Durable Medical Equipment & Medical Supplies
  • Mesa, AZ
  • NPI 1386462810
  NPD
• Banner-University Medical Group

  • Nutrition Education Nutritionist
  • Tucson, AZ
  • NPI 1639842677
  NPD
• Banner-University Medical Group

  • Durable Medical Equipment & Medical Supplies
  • Tucson, AZ
  • NPI 1922820935
  NPD

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767225600000",
    "number": "1912048703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5310 W THUNDERBIRD RD STE W311",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853064706",
            "telephone_number": "602-865-4230",
            "fax_number": "602-865-4250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5310 W THUNDERBIRD RD STE W311",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853064706",
            "telephone_number": "602-865-4230",
            "fax_number": "602-865-4250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SROUR MALLAH",
        "first_name": "HUSAM",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-12",
        "last_updated": "2026-01-01",
        "certification_date": "2026-01-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AZ",
            "license": "50552",
            "primary": false
        },
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "AZ",
            "license": "50552",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katrina M Spradling, FNP-C
• Jasmine Sra, M.D.
• Dharmashree Sreedhar, M.D.
• Srivani Srikantiah, M.D. PLLC
• Namun Shanti Srivastava, MD
• Ssa Acu Endeavors LLC (Modern Accupuncture)
• Sara Colleen St. John
• Thylma Lynn Sta Maria, MD
• Stacey C. Layman DDS PLLC
• Stacie L Westen OD PLLC

• Pediatric Gastroenterology Physician in Glendale, AZ
• Providers in Glendale, AZ by specialty
• Pediatric Gastroenterology Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 1, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.