Basic Information
| Provider Information | |||||||||
| NPI: | 1154064871 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LABIB | ||||||||
| FirstName: | BESHOUI | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1005 DR DB TODD JR BLVD # 300 | ||||||||
| Address2: | |||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 372083501 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | MEHARRY MEDICAL COLLEGE 1005 DR. D B TODD JR. BLVD. N | ||||||||
| Address2: | |||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 37208 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6153276168 | ||||||||
| FaxNumber: | 6153275634 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/20/2022 | ||||||||
| LastUpdateDate: | 04/20/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/05/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | Y | Student, Health Care | Student in an Organized Health Care Education/Training Program |
No ID Information.