Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RR0500X | Rheumatology | MD207194 | LA |
Y | 207RR0500X | Rheumatology | S0676 | TX |
NPI | 1023300910 |
---|---|
Provider Name | Haidy Ibrahim Gohar Galous |
First Address | Dallas, TX 75284-7208 |
Second Address | Dallas, TX 75390-4228 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/05/2011 |
Last Update Date | 03/05/2021 |