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Individual
KETTI AWAD
Active
Individual
KETTI AWAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
L6271
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
158313002
—
TX
05
—
158313003
—
TX
01
—
8EK654
BCBS
TX
01
—
8FT466
BCBS
TX
01
—
P01392339
RR MEDICARE
TX
Enumeration date
06/08/2005
Last updated
08/09/2019
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