Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | N2986 | TX |
NPI | 1013964766 |
---|---|
Provider Name | Elie B Choufani |
First Address | Fort Worth, TX 76104-3243 |
Second Address | Fort Worth, TX 76104-3243 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/05/2006 |
Last Update Date | 14/01/2013 |