Provider Demographics
NPI:1093903007
Name:SOOMAR-KHERAJ, ASHRAF A (DC)
Entity Type:Individual
Prefix:DR
First Name:ASHRAF
Middle Name:A
Last Name:SOOMAR-KHERAJ
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4300 N JOSEY LN STE 104
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75010-4578
Mailing Address - Country:US
Mailing Address - Phone:972-317-0680
Mailing Address - Fax:972-317-0690
Practice Address - Street 1:4300 N JOSEY LN STE 104
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75010-4578
Practice Address - Country:US
Practice Address - Phone:972-317-0680
Practice Address - Fax:972-317-0690
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-04
Last Update Date:2024-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10490111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1528215563OtherGROUP NPI (RENDERING)