Provider Demographics
NPI:1225458904
Name:EMBABI, AHMED
Entity Type:Individual
Prefix:
First Name:AHMED
Middle Name:
Last Name:EMBABI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 E TAYLOR ST STE 304
Mailing Address - Street 2:
Mailing Address - City:SHERMAN
Mailing Address - State:TX
Mailing Address - Zip Code:75090-2880
Mailing Address - Country:US
Mailing Address - Phone:903-957-7246
Mailing Address - Fax:903-927-0049
Practice Address - Street 1:600 E TAYLOR ST STE 304
Practice Address - Street 2:
Practice Address - City:SHERMAN
Practice Address - State:TX
Practice Address - Zip Code:75090
Practice Address - Country:US
Practice Address - Phone:903-957-7246
Practice Address - Fax:903-927-0049
Is Sole Proprietor?:No
Enumeration Date:2014-04-22
Last Update Date:2023-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR7725207LP2900X, 208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine