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General NPI Number Information
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NPI Number | 1811690035
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Entity Type | Individual
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Provider Name | PETER NADY ISHAK GEORGEI
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Gender | Male
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Dates
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Enumeration Date | 03/27/2023
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Last Update Date | 03/08/2024
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Provider Practice Location Address
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Address Line | 3802 CEDAR SPRINGS RD
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City | DALLAS
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State | TX
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Zip | 75219-4149
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Country | US
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Telephone | 214-443-5160
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Fax | 214-443-0741
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Provider Business Mailing Address
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Address Line | 529 SOUTHWESTERN DR
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City | ROCKWALL
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State | TX
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Zip | 75087-8418
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Country | US
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Telephone | 903-240-8590
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | 43550
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 73768
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License Number State | TX
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