Provider Demographics
NPI:1841359239
Name:GOHARKHAY, NIMA (MD, PHD)
Entity type:Individual
Prefix:
First Name:NIMA
Middle Name:
Last Name:GOHARKHAY
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 420
Mailing Address - Street 2:
Mailing Address - City:FRIENDSWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77549-0420
Mailing Address - Country:US
Mailing Address - Phone:281-707-0939
Mailing Address - Fax:
Practice Address - Street 1:1411 ATLANTIS DR STE A
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:TX
Practice Address - Zip Code:77598-1637
Practice Address - Country:US
Practice Address - Phone:817-070-9392
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-08
Last Update Date:2022-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM1114207VM0101X, 207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX175482202Medicaid
TXI39270Medicare UPIN
TXI39270Medicare UPIN