Provider Demographics
NPI:1407058530
Name:GOROUHI, FARIBORZ (MD)
Entity Type:Individual
Prefix:DR
First Name:FARIBORZ
Middle Name:
Last Name:GOROUHI
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 1:2705 HOSPITAL DR
Mailing Address - Street 2:SUITE 401
Mailing Address - City:VICTORIA
Mailing Address - State:TX
Mailing Address - Zip Code:77901-5775
Mailing Address - Country:US
Mailing Address - Phone:361-582-7949
Mailing Address - Fax:361-582-7945
Practice Address - Street 1:2705 HOSPITAL DR
Practice Address - Street 2:SUITE 401
Practice Address - City:VICTORIA
Practice Address - State:TX
Practice Address - Zip Code:77901-5775
Practice Address - Country:US
Practice Address - Phone:361-582-7949
Practice Address - Fax:361-582-7945
Is Sole Proprietor?:No
Enumeration Date:2007-06-01
Last Update Date:2013-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD431936207R00000X
FLME101878207RH0003X
ND12008207RH0003X
TXP7920207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine