Provider Demographics
NPI:1649222829
Name:ALTAHER, GHADA H (MD)
Entity Type:Individual
Prefix:
First Name:GHADA
Middle Name:H
Last Name:ALTAHER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1600 MEDICAL CENTER DR
Mailing Address - Street 2:SUITE 120
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79902-5002
Mailing Address - Country:US
Mailing Address - Phone:915-545-2700
Mailing Address - Fax:915-545-2701
Practice Address - Street 1:1600 MEDICAL CENTER DR
Practice Address - Street 2:SUITE 120
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902-5002
Practice Address - Country:US
Practice Address - Phone:915-545-2700
Practice Address - Fax:915-545-2701
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2008-08-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXL9997207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX173225701Medicaid
TXH64793Medicare UPIN
TX8E0284Medicare PIN