Provider Demographics
NPI:1609151133
Name:TAWFIK, JUSTIN ANDREW (MD)
Entity Type:Individual
Prefix:DR
First Name:JUSTIN
Middle Name:ANDREW
Last Name:TAWFIK
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 841161
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-1161
Mailing Address - Country:US
Mailing Address - Phone:918-579-3987
Mailing Address - Fax:918-579-7598
Practice Address - Street 1:800 W CENTRAL TEXAS EXPY STE 370
Practice Address - Street 2:
Practice Address - City:HARKER HEIGHTS
Practice Address - State:TX
Practice Address - Zip Code:76548-3201
Practice Address - Country:US
Practice Address - Phone:254-618-4320
Practice Address - Fax:254-618-4325
Is Sole Proprietor?:No
Enumeration Date:2011-10-16
Last Update Date:2021-06-15
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Provider Licenses
StateLicense IDTaxonomies
FLME109142208600000X
CAA130492208600000X
TXR1139208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery