Provider Demographics
NPI:1275004236
Name:S.R. KHALAFI, M.D., P.A.
Entity Type:Organization
Organization Name:S.R. KHALAFI, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:SEYED
Authorized Official - Middle Name:REZA
Authorized Official - Last Name:KHALAFI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:817-885-7442
Mailing Address - Street 1:900 W ROSEDALE ST
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76104-4681
Mailing Address - Country:US
Mailing Address - Phone:817-885-7442
Mailing Address - Fax:817-885-7443
Practice Address - Street 1:900 W ROSEDALE ST
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76104-4681
Practice Address - Country:US
Practice Address - Phone:817-885-7442
Practice Address - Fax:817-885-7443
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-16
Last Update Date:2018-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Single Specialty