Active NPI
Amani Rafik Gobran, MD
- Plastic Surgery within the Head & Neck (Otolaryngology) Physician
- Houston, TX
National Provider Identifier
1790818342
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Plastic Surgery within the Head & Neck (Otolaryngology) Physician
- License
- H6247
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 040006005 | Other | TX | RAIL ROAD MEDICARE |
| 10019892 | Other | TX | AMERIGROUP |
| 389996 | Other | TX | WELLCARE |
| 103959601 | Medicaid | TX | |
| 83T881 | Other | TX | BCBS |
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
| License | State | Type | Specialty |
|---|---|---|---|
| H6247 | TX | MD | Plastic 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.