Provider Demographics
NPI:1114922507
Name:TAFEL, ROBERT M (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:M
Last Name:TAFEL
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 1:469 WESTPARK WAY
Mailing Address - Street 2:
Mailing Address - City:EULESS
Mailing Address - State:TX
Mailing Address - Zip Code:76040-3957
Mailing Address - Country:US
Mailing Address - Phone:817-283-2888
Mailing Address - Fax:817-283-1181
Practice Address - Street 1:469 WESTPARK WAY
Practice Address - Street 2:
Practice Address - City:EULESS
Practice Address - State:TX
Practice Address - Zip Code:76040-3957
Practice Address - Country:US
Practice Address - Phone:817-283-2888
Practice Address - Fax:817-283-1181
Is Sole Proprietor?:No
Enumeration Date:2005-06-14
Last Update Date:2011-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD8831207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
87X475Medicare UPIN
87X475Medicare PIN
C22444Medicare UPIN