Basic Information
| Provider Information | |||||||||
| NPI: | 1083059257 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BADOGHAISH | ||||||||
| FirstName: | WALEED | ||||||||
| MiddleName: | OMAR | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3800 RESERVOIR RD, NW | ||||||||
| Address2: | INTERNAL MEDICINE /GASTROENTEROLOGY | ||||||||
| City: | WASHINGTON | ||||||||
| State: | DC | ||||||||
| PostalCode: | 20007 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2024444034 | ||||||||
| FaxNumber: | 2024447797 | ||||||||
| Practice Location | |||||||||
| Address1: | 1400 S COULTER ST | ||||||||
| Address2: | UNIT MANAGER FOR GME, TTUHSC | ||||||||
| City: | AMARILLO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 791061786 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8063545417 | ||||||||
| FaxNumber: | 8063513787 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/01/2013 | ||||||||
| LastUpdateDate: | 09/13/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | 1002215125 | ZZ | Y | Student, Health Care | Student in an Organized Health Care Education/Training Program |
No ID Information.