Individual
ELIAS GHANDOUR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
10208 QUAKER AVE STE 200, LUBBOCK, TX 79424-8394
(806) 795-4500
(806) 516-5400
Mailing address
4515 MARSHA SHARP FWY, LUBBOCK, TX 79407-2520
(067) 447-2238
(806) 740-3325
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
H4930
TX
207RG0100X
Gastroenterology Physician
Primary
H4930
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
113568304
—
TX
Enumeration date
06/15/2006
Last updated
04/08/2024
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