Provider Demographics
NPI:1114989746
Name:EL-ASHRAM, NAYER B (MD)
Entity Type:Individual
Prefix:
First Name:NAYER
Middle Name:B
Last Name:EL-ASHRAM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 HOSPITAL DR STE 111
Mailing Address - Street 2:
Mailing Address - City:CORSICANA
Mailing Address - State:TX
Mailing Address - Zip Code:75110-2489
Mailing Address - Country:US
Mailing Address - Phone:903-641-3815
Mailing Address - Fax:903-641-3863
Practice Address - Street 1:2301 S FM 51 STE 300
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:TX
Practice Address - Zip Code:76234-3864
Practice Address - Country:US
Practice Address - Phone:940-627-1435
Practice Address - Fax:940-627-1453
Is Sole Proprietor?:No
Enumeration Date:2006-04-06
Last Update Date:2020-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH9071207RP1001X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX034345104Medicaid
TX034345105Medicaid
TXPENDINGOtherBCBSTX
TX00K19YOtherBLUE CROSS/BLUE SHIELD
TX034345103Medicaid
TXPENDINGMedicaid
TX267087YNAQMedicare PIN
TX324064YXZ4Medicare PIN
TX00K19YOtherBLUE CROSS/BLUE SHIELD
TX034345105Medicaid
TX00775HMedicare PIN