MEDICARE: SALAH Y GHOBRIAL MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RP1001X	Pulmonary Disease Physician	D8230	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1518955525
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SALAH Y GHOBRIAL MD

Provider Business Mailing Address
First Line	:	PO BOX 8307
Second Line	:
City	:	THE WOODLANDS
State	:	TX
Zip	:	77387-8307
Country	:	US
Telephone Number	:	281-537-6300
Fax Number	:	281-537-7575

Provider Business Practice Location Address
First Line	:	1125 CYPRESS STATION DR
Second Line	:	SUITE E
City	:	HOUSTON
State	:	TX
Zip	:	77090-3054
Country	:	US
Telephone Number	:	281-537-6300
Fax Number	:	281-537-7575

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/12/2005
Last Update Date	:	06/21/2010

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