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General NPI Number Information
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NPI Number | 1639286339
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Entity Type | Individual
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Provider Name | FRED ELIAS GHALI MD
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Gender | Male
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Dates
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Enumeration Date | 08/25/2006
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Last Update Date | 07/28/2025
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Provider Practice Location Address
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Address Line | 1325 W NORTHWEST HWY
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City | GRAPEVINE
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State | TX
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Zip | 76051-3141
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Country | US
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Telephone | 817-421-3376
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Fax | 817-416-4269
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Provider Business Mailing Address
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Address Line | 9900 N CENTRAL EXPY STE 500
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City | DALLAS
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State | TX
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Zip | 75231-0928
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Country | US
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Telephone | 214-987-3376
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Fax | 469-532-0273
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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 | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | J7330
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207NP0225X
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Taxonomy Name | Pediatric Dermatology Physician
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License Number | J7330
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License Number State | TX
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