Provider Demographics
NPI:1275866097
Name:TAFEL, JOHN ANDREWS (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:ANDREWS
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 1:1007 WALTON ROAD
Mailing Address - Street 2:
Mailing Address - City:MATADOR
Mailing Address - State:TX
Mailing Address - Zip Code:79244-0357
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1007 WALTON ROAD
Practice Address - Street 2:
Practice Address - City:MATADOR
Practice Address - State:TX
Practice Address - Zip Code:79244-0357
Practice Address - Country:US
Practice Address - Phone:214-470-2629
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-11
Last Update Date:2009-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH9722208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXH9722OtherSTATE LICENSE