Provider Demographics
NPI:1447690706
Name:GHAZALA, ZENA B (MD)
Entity type:Individual
Prefix:
First Name:ZENA
Middle Name:B
Last Name:GHAZALA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ZENA BASIL BASHIR
Other - Middle Name:
Other - Last Name:GHAZALA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1 CHILDRENS WAY # 653
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72202-3500
Mailing Address - Country:US
Mailing Address - Phone:501-364-1100
Mailing Address - Fax:501-364-4082
Practice Address - Street 1:1 CHILDRENS WAY # 512-17
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72202-3500
Practice Address - Country:US
Practice Address - Phone:501-364-1006
Practice Address - Fax:501-364-3930
Is Sole Proprietor?:No
Enumeration Date:2013-07-01
Last Update Date:2022-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-11915208000000X
CAE-119152080P0214X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0214XAllopathic & Osteopathic PhysiciansPediatricsPediatric Pulmonology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics