Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | S1592 | TX |
NPI | 1003267527 |
---|---|
Provider Name | Gul E Rukh Ferdousi |
First Address | Houston, TX 77094-1298 |
Second Address | Houston, TX 77094-1298 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2016 |
Last Update Date | 08/11/2019 |