Provider Demographics
NPI:1821586488
Name:GHAITH, TONY (MD)
Entity Type:Individual
Prefix:
First Name:TONY
Middle Name:
Last Name:GHAITH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6907 N CAPITAL OF TEXAS HWY STE 240
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731-1710
Mailing Address - Country:US
Mailing Address - Phone:512-362-6789
Mailing Address - Fax:
Practice Address - Street 1:6907 N CAPITAL OF TEXAS HWY STE 240
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731-1710
Practice Address - Country:US
Practice Address - Phone:512-362-6789
Practice Address - Fax:737-272-6740
Is Sole Proprietor?:No
Enumeration Date:2018-04-28
Last Update Date:2021-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS8991207R00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine