Provider Demographics
NPI:1750022406
Name:GAADRA ENTERPRISE PLLC
Entity Type:Organization
Organization Name:GAADRA ENTERPRISE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GAMAL
Authorized Official - Middle Name:A
Authorized Official - Last Name:ELSAIDI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-749-9354
Mailing Address - Street 1:8415 GROVE CREEK DR
Mailing Address - Street 2:
Mailing Address - City:LEWISVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27023-3004
Mailing Address - Country:US
Mailing Address - Phone:336-749-9354
Mailing Address - Fax:
Practice Address - Street 1:575 S 70TH ST STE 310
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68510-2471
Practice Address - Country:US
Practice Address - Phone:336-749-9354
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-06
Last Update Date:2022-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain