Organization
PEDIATRIC DERMATOLOGY OF NO. TX
Active
Parent organization
PEDIATRIC DERMATOLOGY OF NO. TX
Other names
Fred E Ghali, MD
Organization subpart
Yes
Provider details
NPI number
Legal business name
PEDIATRIC DERMATOLOGY OF NO. TX
Authorized official
DR. FRED E GHALI MD (OWNER)
(817) 421-3376
Entity
Organization
Contact information
Practice address
1325 W NORTHWEST HWY, GRAPEVINE, TX 76051-3141
(817) 421-3376
(817) 416-4269
Mailing address
1325 W NORTHWEST HWY, GRAPEVINE, TX 76051-3141
(817) 421-3376
(817) 416-4269
Taxonomy
Speciality
Code
Description
License number
State
207NP0225X
Pediatric Dermatology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1639286339
TYPE 1 NPI
TX
Enumeration date
07/08/2014
Last updated
07/08/2014
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