Provider Demographics
NPI:1265450811
Name:ELSIESY, HUSSIEN A (MD)
Entity type:Individual
Prefix:
First Name:HUSSIEN
Middle Name:A
Last Name:ELSIESY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:777 FOREST LANE
Mailing Address - Street 2:SUITE C339
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75230-1002
Mailing Address - Country:US
Mailing Address - Phone:469-608-4980
Mailing Address - Fax:469-608-4981
Practice Address - Street 1:777 FOREST LANE
Practice Address - Street 2:SUITE C339
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230
Practice Address - Country:US
Practice Address - Phone:469-608-4980
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2025-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR.0062524207RG0100X
NY223659207RG0100X
TXR2585207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology