=====================================================
General NPI Number Information
=====================================================
NPI Number | 1760291330
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | EMPOWER FOR HER
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/07/2025
-----------------------------------------------------
Last Update Date | 04/02/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 525 SHILOH RD STE 2200
-----------------------------------------------------
City | PLANO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75074-7264
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 972-944-8200
-----------------------------------------------------
Fax | 972-954-6010
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1023 WELLINGTON LN
-----------------------------------------------------
City | MURPHY
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75094-4243
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 631-994-6616
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | ATTENDING PHYSICIAN
-----------------------------------------------------
Name | INGY KHATTABY
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 631-994-6616
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207V00000X
-----------------------------------------------------
Taxonomy Name | Obstetrics & Gynecology Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------