Islam, Ebtesam

Islam, Ebtesam is an individual health care provider with primary practice located at 3601 4Th St Ms 9410, Lubbock TX 79430-9410. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pulmonary Disease, Allopathic & Osteopathic Physicians / Critical Care Medicine. Allopathic & Osteopathic Physicians / Critical Care Medicine is her primary health care specialty. Islam, Ebtesam can be contacted via phone (806) 743-3155.

Contact Information

Primary practice address
3601 4Th St Ms 9410 Lubbock TX 79430-9410
Phone: (806) 743-3155
Fax: (806) 743-3143
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pulmonary Disease 207RP1001X R0253 Texas
Allopathic & Osteopathic Physicians / Critical Care Medicine 207RC0200X R0253 Texas

Profile Details

NPI number 1710208913
LBN Legal business name Islam, Ebtesam
Credentials M.D., PH.D.
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 22nd, 2010
Last updated Nov 10th, 2021 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1710208913 NPPES
Texas MEDICAID 363703501

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