Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0007X | Plastic Surgeon (Head & Neck) | H6247 | TX |
NPI | 1790818342 |
---|---|
Provider Name | Dr. Amani Rafik Gobran |
First Address | Houston, TX 77015-4368 |
Second Address | Houston, TX 77015 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/03/2007 |
Last Update Date | 27/06/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
040006005 | RAIL ROAD MEDICARE (01) | TX |
10019892 | AMERIGROUP (01) | TX |
103959601 | (05) | TX |
389996 | WELLCARE (01) | TX |
83T881 | BCBS (01) | TX |
F44259 | (02) |