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General NPI Number Information
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NPI Number | 1043959737
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Entity Type | Individual
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Provider Name | AYMAN G GHATTAS
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Gender | Male
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Dates
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Enumeration Date | 06/01/2022
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Last Update Date | 06/01/2022
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Provider Practice Location Address
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Address Line | 1592 S LOOP 288
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City | DENTON
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State | TX
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Zip | 76205-4730
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Country | US
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Telephone | 940-566-5252
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Fax |
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Provider Business Mailing Address
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Address Line | 3529 BEEKMAN DR
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City | FORT WORTH
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State | TX
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Zip | 76244-9429
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Country | US
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Telephone | 816-267-1905
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 69921
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License Number State | TX
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