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EBTESAM ISLAM M.D. PH.D. NPI 1710208913


NPI Information

NPI: 1710208913
Provider Name: EBTESAM ISLAM, M.D., PH.D.
Classification: Internal Medicine - 207RC0200X
Entity Type: Individual

Specialization: Critical Care Medicine

Organization: TEXAS TECH UNIVERSITY HEALTH SCIENCES CENTER LUBBOCK

PECOS Registration: Yes

Address:
3601 4TH ST
MS 9410
LUBBOCK, TX
ZIP 79430
Phone: (806) 743-3155
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Ebtesam Islam, M.D., PH.D. is a critical care medicine internal medicine in Lubbock, TX with 15 years of experience. The provider is an internist who diagnoses, treats and supports patients with multiple organ dysfunction. This specialist may have administrative responsibilities for intensive care units and may also facilitate and coordinate patient care among the primary physician, the critical care staff and other specialists. Ebtesam Islam, M.D., PH.D. NPI is 1710208913. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: TEXAS TECH UNIVERSITY HEALTH SCIENCE CENTER SCHOOL OF MEDICINE
Graduation Year:2009

The provider's business location address is:

3601 4TH ST
MS 9410
LUBBOCK, TX
ZIP 79430-410
Phone: (806) 743-3155
Fax: (806) 743-3143

The NPI 1710208913 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 6/22/2010 and was last updated on 11/10/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207RP1001XInternal MedicinePulmonary DiseaseR0253TEXASNo
2207RC0200XInternal MedicineCritical Care MedicineR0253TEXASYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1363703501MEDICAIDTEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.