Individual
DR. BASSAM GHABACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1500 S MAIN ST, FORT WORTH, TX 76104-4917
(817) 927-3941
Mailing address
1500 S MAIN ST, FORT WORTH, TX 76104-4917
(817) 927-3941
Taxonomy
Speciality
Code
Description
License number
State
207RX0202X
Medical Oncology Physician
Primary
04-35498
KS
207RX0202X
Medical Oncology Physician
25355
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200841860A
—
KS
Enumeration date
02/16/2007
Last updated
10/29/2014
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