Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207SG0201X | Clinical Genetics (M.D.) | E7140 | TX |
N | 207V00000X | Obstetrician & Gynecologist | E7140 | TX |
NPI | 1568574267 |
---|---|
Provider Name | Mr. Gabriel S Khodr |
First Address | San Antonio, TX 78229 |
Second Address | San Antonio, TX 78229 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B23930 | (02) |