Healthcare Provider Details
I. General information
NPI: 1508845744
Provider Name (Legal Business Name): GHULAM M ARAIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 01/16/2006
Last Update Date: 09/12/2024
Certification Date: 09/12/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9250 PINECROFT DR # N2.101
SHENANDOAH TX
77380
US
IV. Provider business mailing address
909 FROSTWOOD DR STE 1.100
HOUSTON TX
77024-2301
US
V. Phone/Fax
- Phone: 713-897-5539
- Fax: 713-897-2275
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207QG0300X |
| Taxonomy | Geriatric Medicine (Family Medicine) Physician |
| License Number | R1693 |
| License Number State | TX |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208M00000X |
| Taxonomy | Hospitalist Physician |
| License Number | R1693 |
| License Number State | TX |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | MD.12914R |
| License Number State | LA |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | R1693 |
| License Number State | TX |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208M00000X |
| Taxonomy | Hospitalist Physician |
| License Number | MD.12914R |
| License Number State | LA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: