Provider Demographics
NPI:1679838940
Name:SHAFA MEDICAL SERVICES, PLLC
Entity Type:Organization
Organization Name:SHAFA MEDICAL SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:RAMIN
Authorized Official - Middle Name:
Authorized Official - Last Name:ROUFEH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:940-612-8760
Mailing Address - Street 1:4821 CYPRESS PT
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-6825
Mailing Address - Country:US
Mailing Address - Phone:940-612-8760
Mailing Address - Fax:940-665-0209
Practice Address - Street 1:2024 W HIGHWAY 82
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:TX
Practice Address - Zip Code:76240-2051
Practice Address - Country:US
Practice Address - Phone:940-612-8760
Practice Address - Fax:940-665-0209
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-11
Last Update Date:2012-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN4048208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Single Specialty