Basic Information
| Provider Information | |||||||||
| NPI: | 1023320637 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GHUFRAN | ||||||||
| FirstName: | AIMAN | ||||||||
| MiddleName: | |||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8201 EWING HALSELL DR | ||||||||
| Address2: | |||||||||
| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782293707 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2105754837 | ||||||||
| FaxNumber: | 2105758647 | ||||||||
| Practice Location | |||||||||
| Address1: | 8201 EWING HALSELL DR | ||||||||
| Address2: | |||||||||
| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782293707 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2105754837 | ||||||||
| FaxNumber: | 2105758647 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/12/2010 | ||||||||
| LastUpdateDate: | 08/08/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/08/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | T2868 | TX | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RG0100X | 56254 | WI | N | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology | 207RG0100X | T2868 | TX | N | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology | 207RI0008X | 56254-020 | WI | N | Allopathic & Osteopathic Physicians | Internal Medicine | Hepatology | 207RI0008X | T2868 | TX | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Hepatology |
ID Information
| ID | Type | State | Issuer | Description | 1023320637 | 05 | WI | MEDICAID |