Provider Demographics
NPI:1407885262
Name:M AYMAN GHRAOWI, MD PA
Entity Type:Organization
Organization Name:M AYMAN GHRAOWI, MD PA
Other - Org Name:NORTHWEST CANCER CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:M AYMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:GHRAOWI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:361-885-0390
Mailing Address - Street 1:PO BOX 5407
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78465-5407
Mailing Address - Country:US
Mailing Address - Phone:361-885-0390
Mailing Address - Fax:361-904-0178
Practice Address - Street 1:14120 NORTHWEST BLVD
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78410-5121
Practice Address - Country:US
Practice Address - Phone:361-241-6990
Practice Address - Fax:361-241-6991
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0065AZMedicare ID - Type Unspecified