Provider Demographics
NPI:1437946829
Name:ELGOHARY, MAALY
Entity type:Individual
Prefix:
First Name:MAALY
Middle Name:
Last Name:ELGOHARY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:508 OLDHAM ST
Mailing Address - Street 2:
Mailing Address - City:LEAGUE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77573-7531
Mailing Address - Country:US
Mailing Address - Phone:330-881-6334
Mailing Address - Fax:
Practice Address - Street 1:2800 W MAIN ST STE H
Practice Address - Street 2:
Practice Address - City:LEAGUE CITY
Practice Address - State:TX
Practice Address - Zip Code:77573-1809
Practice Address - Country:US
Practice Address - Phone:346-291-2922
Practice Address - Fax:346-291-2922
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-21
Last Update Date:2025-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX68185183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist