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General NPI Number Information
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NPI Number | 1467523886
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Entity Type | Individual
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Provider Name | MOHAMED TAREK ELGHETANY M.D.
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Gender | Male
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Dates
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Enumeration Date | 11/10/2006
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Last Update Date | 03/03/2011
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Provider Practice Location Address
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Address Line | 6621 FANNIN STREET TEXAS CHILDREN'S HOSPITAL DEPARTMENT OF PATHOLOGY
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City | HOUSTON
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State | TX
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Zip | 77030
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Country | US
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Telephone | 832-824-5122
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Fax | 832-825-5110
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Provider Business Mailing Address
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Address Line | 6621 FANNIN STREET DEPARTMENT OF PATHOLOGY, TCH, SUITE WB 1100
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City | HOUSTON
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State | TX
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Zip | 77030
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Country | US
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Telephone | 832-824-5122
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Fax | 832-825-5110
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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 | 207ZP0105X
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Taxonomy Name | Clinical Pathology/Laboratory Medicine Physician
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License Number | H2356
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207ZH0000X
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Taxonomy Name | Hematology (Pathology) Physician
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License Number | H2356
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License Number State | TX
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