Individual
MR. EZAM GHODSI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5301 DAVIS LN BLDG A200, AUSTIN, TX 78749-4062
(512) 494-4000
(512) 494-4090
Mailing address
7940 SHOAL CREEK BLVD STE 100, AUSTIN, TX 78757-7589
(512) 494-4000
(512) 494-4090
Taxonomy
Speciality
Code
Description
License number
State
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
Primary
H7420
TX
2084S0012X
Sleep Medicine (Psychiatry & Neurology) Physician
H7420
TX
Other
Enumeration date
04/26/2006
Last updated
06/10/2021
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