Provider Demographics
NPI:1578607172
Name:KLAFF, ADAM JOSEPH (PA-C)
Entity Type:Individual
Prefix:
First Name:ADAM
Middle Name:JOSEPH
Last Name:KLAFF
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2821 E PRESIDENT GEORGE BUSH HWY STE 407
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75082-4279
Mailing Address - Country:US
Mailing Address - Phone:972-680-0668
Mailing Address - Fax:972-680-3312
Practice Address - Street 1:2821 E PRESIDENT GEORGE BUSH HWY STE 407
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75082-4279
Practice Address - Country:US
Practice Address - Phone:972-680-0668
Practice Address - Fax:972-680-3312
Is Sole Proprietor?:No
Enumeration Date:2007-02-16
Last Update Date:2020-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA04407363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX280991502Medicaid
TX280991503Medicaid
TXP00987194OtherRAILROAD
TXPA04407OtherSTATE LICENSE