Provider Demographics
NPI:1295392306
Name:EL-BKAILY, RAMI MARWAN (OD)
Entity Type:Individual
Prefix:DR
First Name:RAMI
Middle Name:MARWAN
Last Name:EL-BKAILY
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1411 N BECKLEY AVE
Mailing Address - Street 2:STE 460
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75203-1269
Mailing Address - Country:US
Mailing Address - Phone:734-306-1566
Mailing Address - Fax:
Practice Address - Street 1:4100 W AIRPORT FWY UNIT 100
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75062
Practice Address - Country:US
Practice Address - Phone:972-986-9778
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-23
Last Update Date:2021-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4901005356152W00000X
TX9814T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist