Organization
FADI G. GHANEM, MD PA
Active
Other names
Maternal and Family Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FADI G GHANEM M.D. (PRESIDENT)
(281) 419-1599
Entity
Organization
Contact information
Practice address
1111 MEDICAL PLAZA DR, SUITE 230, THE WOODLANDS, TX 77380-3476
(281) 419-1599
(281) 898-7632
Mailing address
PO BOX 7727, SPRING, TX 77387-7727
(281) 419-1599
(281) 898-7632
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
H8071
TX
291U00000X
Clinical Medical Laboratory
H8071
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00013DM
BCBS GROUP
TX
05
—
0806481-01
—
TX
Enumeration date
04/13/2007
Last updated
08/18/2015
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