Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204F00000X | Transplant Surgeon | R5193 | TX |
N | 208200000X | Surgeon | NOT KNOWN | MD |
N | 208600000X | Surgeon | NOT KNOWN | MD |
NPI | 1518273986 |
---|---|
Provider Name | Dr. Ashraf Ibrahim Reyad |
First Address | Fort Worth, TX 76104-3916 |
Second Address | Fort Worth, TX 76104-3916 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/08/2010 |
Last Update Date | 16/12/2019 |