Provider Demographics
NPI:1174035117
Name:TEXOMA LIVER CENTER PLLC
Entity Type:Organization
Organization Name:TEXOMA LIVER CENTER PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HESHAM
Authorized Official - Middle Name:
Authorized Official - Last Name:ELGOUHARI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:903-416-6110
Mailing Address - Street 1:5012 S US HIGHWAY 75 STE 220
Mailing Address - Street 2:
Mailing Address - City:DENISON
Mailing Address - State:TX
Mailing Address - Zip Code:75020-4598
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5012 S US HIGHWAY 75 STE 220
Practice Address - Street 2:
Practice Address - City:DENISON
Practice Address - State:TX
Practice Address - Zip Code:75020-4598
Practice Address - Country:US
Practice Address - Phone:903-416-6110
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-31
Last Update Date:2017-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RI0008XAllopathic & Osteopathic PhysiciansInternal MedicineHepatologyGroup - Multi-Specialty