Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | AP127910 | TX |
NPI | 1194121418 |
---|---|
Provider Name | Magidah Reem Kobty |
First Address | Fort Worth, TX 76134-3421 |
Second Address | Fort Worth, TX 76104-2733 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/11/2014 |
Last Update Date | 01/05/2015 |