Provider Demographics
NPI:1073516464
Name:SAFRO, IVOR L (MD)
Entity Type:Individual
Prefix:DR
First Name:IVOR
Middle Name:L
Last Name:SAFRO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:920 FROSTWOOD DR
Mailing Address - Street 2:STE 530
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-2413
Mailing Address - Country:US
Mailing Address - Phone:713-465-9390
Mailing Address - Fax:713-465-9718
Practice Address - Street 1:920 FROSTWOOD DR
Practice Address - Street 2:STE 530
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-2413
Practice Address - Country:US
Practice Address - Phone:713-465-9390
Practice Address - Fax:713-465-9718
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-31
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE8878207V00000X, 207VE0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Not Answered207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive Endocrinology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXBC TXOther00BP68
TX8B7773Medicare ID - Type UnspecifiedINDIVIDUAL MC #
TXBC TXOther00BP68