MEDICARE: MOHEB NABIL BOKTOR

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	207R00000X	Internal Medicine Physician	MD.203838	LA
2	207RG0100X	Gastroenterology Physician	MD.203838	LA
3	207RG0100X	Gastroenterology Physician	R9190	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

General Provider Information

NPI Number	:	1811187354
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MOHEB NABIL BOKTOR

Provider Business Mailing Address
First Line	:	P.O.BOX 845347
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75284-7208
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6201 HARRY HINES BLVD
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75390-4228
Country	:	US
Telephone Number	:	214-645-6355
Fax Number	:

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

Provider Enumeration Date	:	07/31/2007
Last Update Date	:	01/08/2019

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Directions to “ MOHEB NABIL BOKTOR ” Practice Location

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