Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 240663 | NY |
N | 208600000X | Surgeon | 240663 | NY |
Y | 208200000X | Surgeon | M7486 | TX |
Y | 208600000X | Surgeon | M7486 | TX |
N | 2086S0122X | Plastic and Reconstructive Surgery | 240663 | NY |
NPI | 1295941169 |
---|---|
Provider Name | Sacha Imran Obaid |
First Address | Southlake, TX 76092-6280 |
Second Address | Southlake, TX 76092-6422 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/05/2007 |
Last Update Date | 01/10/2019 |