1750503728 NPI number — DR. GHADA H ABDALLAH O.D.

Table of content: MS. JOAN MCPHERSON FOREST LICSW (NPI 1821105214)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1750503728 NPI number — DR. GHADA H ABDALLAH O.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ABDALLAH
Provider First Name:
GHADA
Provider Middle Name:
H
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
O.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
HASBANI
Provider Other First Name:
GHADA
Provider Other Middle Name:
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
O.D.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1750503728
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/28/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1010 OLD AUSTIN HUTTO RD
Provider Second Line Business Mailing Address:
STE 100
Provider Business Mailing Address City Name:
PFLUGERVILLE
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78660-4219
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
512-252-7075
Provider Business Mailing Address Fax Number:
512-252-8825

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1010 OLD AUSTIN HUTTO RD
Provider Second Line Business Practice Location Address:
STE 100
Provider Business Practice Location Address City Name:
PFLUGERVILLE
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78660-4219
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
512-252-7075
Provider Business Practice Location Address Fax Number:
512-252-8825
Provider Enumeration Date:
05/02/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 152WC0802X , with the licence number:  4843-T1708 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 152WC0802X , with the licence number: 5405TG , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)