Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | E4557 | TX |
NPI | 1003814310 |
---|---|
Provider Name | Ghulam Murtaza |
First Address | Dallas, TX 75303-1173 |
Second Address | Houston, TX 77030 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/07/2005 |
Last Update Date | 10/10/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00508U | MEDICARE GROUP PIN (01) | TX |
160059760 | (05) | TX |
B25046 | (02) | TX |