Provider Demographics
NPI:1013573948
Name:ORFALY MEDICAL PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:ORFALY MEDICAL PROFESSIONAL CORPORATION
Other - Org Name:BROADWAY ELITE MEDICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HAYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ORFALY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:469-745-1952
Mailing Address - Street 1:3200 BROADWAY BLVD STE 180
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75043-1572
Mailing Address - Country:US
Mailing Address - Phone:469-745-1952
Mailing Address - Fax:469-745-1953
Practice Address - Street 1:3200 BROADWAY BLVD STE 180
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75043-1572
Practice Address - Country:US
Practice Address - Phone:469-745-1952
Practice Address - Fax:469-745-1953
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-16
Last Update Date:2019-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty