Provider Demographics
NPI:1558392506
Name:NUMAJIRI, AKIRA STUART (MD)
Entity Type:Individual
Prefix:
First Name:AKIRA
Middle Name:STUART
Last Name:NUMAJIRI
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 1:3434 SWISS AVE
Mailing Address - Street 2:SUITE 204
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75204-6251
Mailing Address - Country:US
Mailing Address - Phone:214-828-5044
Mailing Address - Fax:214-841-9301
Practice Address - Street 1:3434 SWISS AVE
Practice Address - Street 2:SUITE 204
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75204-6251
Practice Address - Country:US
Practice Address - Phone:214-828-5044
Practice Address - Fax:214-841-9301
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2022-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ4397207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX103460502Medicaid
TX1508723-05Medicaid
TX318173YNQJMedicare PIN
TX82Y510Medicare ID - Type Unspecified
TX103460502Medicaid