Basic Information
Provider Information
NPI: 1831466820
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MOUGHRABI
FirstName: NIZAR
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: NP, RN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 7401 S. MAIN
Address2: FONDREN ORTHOPEDIC GROUP L.L.P.
City: HOUSTON
State: TX
PostalCode: 770304509
CountryCode: US
TelephoneNumber: 7137992300
FaxNumber: 7137943380
Practice Location
Address1: 7401 S. MAIN
Address2: FONDREN ORTHOPEDIC GROUP L.L.P.
City: HOUSTON
State: TX
PostalCode: 770304509
CountryCode: US
TelephoneNumber: 7137992300
FaxNumber: 7137943380
Other Information
ProviderEnumerationDate: 11/19/2011
LastUpdateDate: 11/19/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
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AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163W00000X744983TXN Nursing Service ProvidersRegistered Nurse 
363LF0000XF0711381TXY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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