Provider Demographics
NPI:1568443562
Name:JAFARNIA, KOUROSH (MD)
Entity Type:Individual
Prefix:
First Name:KOUROSH
Middle Name:
Last Name:JAFARNIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:KORSH
Other - Middle Name:
Other - Last Name:JAFARNIA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:13802 CENTERFIELD DR
Mailing Address - Street 2:STE 300
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77070-6044
Mailing Address - Country:US
Mailing Address - Phone:281-737-0999
Mailing Address - Fax:281-737-0926
Practice Address - Street 1:13802 CENTERFIELD RD
Practice Address - Street 2:SUITE 300
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-6044
Practice Address - Country:US
Practice Address - Phone:281-737-0999
Practice Address - Fax:281-737-0926
Is Sole Proprietor?:No
Enumeration Date:2005-11-08
Last Update Date:2014-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK7171207X00000X, 207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX153386104Medicaid
TX8DY922OtherBLUE CROSS BLUE SHIELD
TX1568443562OtherBLUE CROSS BLUE SHIELD
TXP00904735OtherMEDICARE RR
TX153386103Medicaid
TX153386102Medicaid
TXP01070532OtherRR MEDICARE
TXH40728Medicare UPIN
TX153386102Medicaid
TX306276YMVQMedicare PIN
TX8993B6Medicare PIN
TXP00904735OtherMEDICARE RR