Provider Demographics
NPI:1255860177
Name:ALKHATIB, AMIRA ROSE (DO)
Entity Type:Individual
Prefix:
First Name:AMIRA
Middle Name:ROSE
Last Name:ALKHATIB
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:810 HOSPITAL DR STE 100
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77701-4633
Mailing Address - Country:US
Mailing Address - Phone:409-212-5933
Mailing Address - Fax:
Practice Address - Street 1:3070 COLLEGE ST STE 202
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77701-4688
Practice Address - Country:US
Practice Address - Phone:409-212-7100
Practice Address - Fax:409-212-7140
Is Sole Proprietor?:No
Enumeration Date:2017-06-05
Last Update Date:2021-10-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXS9839207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics