Individual provider Active NPI

Amani Rafik Gobran, MD

  • Plastic Surgery within the Head & Neck (Otolaryngology) Physician
  • Houston, TX
National Provider Identifier
1790818342
Registry record updated Jun 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery within the Head & Neck (Otolaryngology) PhysicianTaxonomy code 207YX0007X
License
H6247 Issued in TX
Practice address
1140 Westmont Dr
Ste 445
Houston, TX 77015
Phone
(713) 455-7555
Fax
(713) 455-7771
NPI assigned
Mar 13, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery within the Head & Neck (Otolaryngology) Physician 207YX0007X H6247 TX Primary

Addresses

Primary practice location

1140 Westmont Dr
Ste 445
Houston, TX 77015

Mailing address

1140 Westmont Dr
Ste 445
Houston, TX 77015-4368
Phone (713) 455-7555

Other practice location 1

13111 E Frwy
308
Houston, TX 77015-5819
Phone (713) 455-7555

Other identifiers 5

IdentifierTypeStateIssuer
040006005OtherTXRAIL ROAD MEDICARE
10019892OtherTXAMERIGROUP
389996OtherTXWELLCARE
103959601MedicaidTX
83T881OtherTXBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
H6247TXMDPlastic Surgery within the Head & Neck (Otolaryngology) Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530057600000",
    "number": "1790818342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1140 WESTMONT DR",
            "address_2": "STE 445",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770154368",
            "telephone_number": "713-455-7555",
            "fax_number": "713-455-7771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1140 WESTMONT DR",
            "address_2": "STE 445",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "77015",
            "telephone_number": "713-455-7555",
            "fax_number": "713-455-7771"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13111 E Frwy",
            "address_2": "308",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770155819",
            "country_code": "US",
            "telephone_number": "713-455-7555",
            "fax_number": "713-455-7771",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOBRAN",
        "first_name": "AMANI",
        "middle_name": "RAFIK",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-13",
        "last_updated": "2018-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YX0007X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Plastic Surgery within the Head & Neck",
            "state": "TX",
            "license": "H6247",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "040006005",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "10019892",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "389996",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103959601",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "83T881",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.