Provider Demographics
NPI:1841220092
Name:FREIHA, GHASSAN (MD)
Entity Type:Individual
Prefix:
First Name:GHASSAN
Middle Name:
Last Name:FREIHA
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 1:876 LOOP 337
Mailing Address - Street 2:STE 302
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78130
Mailing Address - Country:US
Mailing Address - Phone:830-625-8088
Mailing Address - Fax:830-629-9215
Practice Address - Street 1:876 LOOP 337
Practice Address - Street 2:STE 302
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78130
Practice Address - Country:US
Practice Address - Phone:830-625-8088
Practice Address - Fax:830-629-9215
Is Sole Proprietor?:No
Enumeration Date:2006-07-04
Last Update Date:2009-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ6439208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX138418209Medicaid
G30190Medicare UPIN
TX85022FMedicare ID - Type Unspecified