=====================================================
General NPI Number Information
=====================================================
NPI Number | 1437444262
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | AMMAR S DHARI M.D.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/09/2011
-----------------------------------------------------
Last Update Date | 12/15/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6651 MAIN ST STE 1020
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77030-2351
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 832-826-7458
-----------------------------------------------------
Fax | 832-825-9348
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 11511 SHADOW CREEK PKWY
-----------------------------------------------------
City | PEARLAND
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77584-7298
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 713-442-0000
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207V00000X
-----------------------------------------------------
Taxonomy Name | Obstetrics & Gynecology Physician
-----------------------------------------------------
License Number | 52960
-----------------------------------------------------
License Number State | TN
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 390200000X
-----------------------------------------------------
Taxonomy Name | Student in an Organized Health Care Education/Training Program
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 207V00000X
-----------------------------------------------------
Taxonomy Name | Obstetrics & Gynecology Physician
-----------------------------------------------------
License Number | Q6314
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------