Provider Demographics
NPI:1790818342
Name:GOBRAN, AMANI RAFIK (MD)
Entity Type:Individual
Prefix:DR
First Name:AMANI
Middle Name:RAFIK
Last Name:GOBRAN
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:1140 WESTMONT DR
Mailing Address - Street 2:STE 445
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77015-4368
Mailing Address - Country:US
Mailing Address - Phone:713-455-7555
Mailing Address - Fax:713-455-7771
Practice Address - Street 1:1140 WESTMONT DR
Practice Address - Street 2:STE 445
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77015
Practice Address - Country:US
Practice Address - Phone:713-455-7555
Practice Address - Fax:713-455-7771
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2018-06-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXH6247207YX0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0007XAllopathic & Osteopathic PhysiciansOtolaryngologyPlastic Surgery within the Head & Neck
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX040006005OtherRAIL ROAD MEDICARE
TX10019892OtherAMERIGROUP
TX389996OtherWELLCARE
TX103959601Medicaid
TX83T881OtherBCBS
F44259Medicare UPIN