Healthcare Provider Details

I. General information

NPI: 1972666949
Provider Name (Legal Business Name): DALIA ELIAS EL BEJJANI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/19/2006
Last Update Date: 10/22/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

313 E 12TH ST SUITE 101
AUSTIN TX
78701-1954
US

IV. Provider business mailing address

313 E 12TH ST SUITE 101
AUSTIN TX
78701-1954
US

V. Phone/Fax

Practice location:
  • Phone: 512-324-9650
  • Fax:
Mailing address:
  • Phone: 512-324-9650
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number35088524
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License NumberN1621
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: