Provider Demographics
NPI:1336193309
Name:ALZAGHRINI, GHASSAN J (MD)
Entity Type:Individual
Prefix:DR
First Name:GHASSAN
Middle Name:J
Last Name:ALZAGHRINI
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 1:2500 FONDREN RD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77063-2321
Mailing Address - Country:US
Mailing Address - Phone:713-917-5725
Mailing Address - Fax:713-917-5794
Practice Address - Street 1:1429 HIGHWAY 6 STE 101
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-5135
Practice Address - Country:US
Practice Address - Phone:832-500-1250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-22
Last Update Date:2020-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK0595207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX47579004Medicaid
84490RMedicare PIN
TX0475790-02Medicaid