Provider Demographics
NPI:1518454438
Name:GHAZAL, ASHNA (MD)
Entity Type:Individual
Prefix:DR
First Name:ASHNA
Middle Name:
Last Name:GHAZAL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 VILLAGE GROVE RD
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72211-2019
Mailing Address - Country:US
Mailing Address - Phone:501-553-6077
Mailing Address - Fax:
Practice Address - Street 1:6263 HARRY HINES BLVD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75235-5217
Practice Address - Country:US
Practice Address - Phone:214-648-3085
Practice Address - Fax:214-353-0604
Is Sole Proprietor?:No
Enumeration Date:2018-04-16
Last Update Date:2018-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP10064769207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine