Individual
DR. MAGED RAMZY BOTROS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
215 E WATER ST, JASPER, TX 75951-4440
(409) 384-6835
Mailing address
215 E WATER ST, JASPER, TX 75951-4440
(409) 384-6835
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
G7787
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110637904
—
TX
01
—
45D0484054
CLIA ID NUMBER
TX
Enumeration date
07/07/2005
Last updated
07/16/2007
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