Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | M6395 | TX |
N | 207RG0100X | Gastroenterologist | MD034817 | DC |
N | 207RG0100X | Gastroenterologist | ME99678 | FL |
NPI | 1013132000 |
---|---|
Provider Name | Dr. Ahmed Nezar Shobassy |
First Address | Dallas, TX 75284-4658 |
Second Address | Round Rock, TX 78665-1032 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/04/2007 |
Last Update Date | 16/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2793369 00 | (05) | FL |