Individual
ELLAHEH EBRAHIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
200 MARTIN LUTHER KING BLVD, WICHITA FALLS, TX 76301-1152
(940) 766-6306
(940) 766-6504
Mailing address
200 MARTIN LUTHER KING BLVD, WICHITA FALLS, TX 76301-1152
(940) 766-6306
(940) 766-6504
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
27109
OK
207Q00000X
Family Medicine Physician
Primary
N8909
TX
281P00000X
Chronic Disease Hospital
27109
OK
282N00000X
General Acute Care Hospital
27109
OK
Other
Enumeration date
12/30/2009
Last updated
04/07/2025
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