Provider Demographics
NPI:1760746895
Name:RELIANCE MEDICAL, PLLC
Entity Type:Organization
Organization Name:RELIANCE MEDICAL, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CMO
Authorized Official - Prefix:DR
Authorized Official - First Name:UZMA
Authorized Official - Middle Name:
Authorized Official - Last Name:JAFRI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:832-768-5370
Mailing Address - Street 1:14139 W GREENTREE DR S
Mailing Address - Street 2:
Mailing Address - City:LITCHFIELD PARK
Mailing Address - State:AZ
Mailing Address - Zip Code:85340-5038
Mailing Address - Country:US
Mailing Address - Phone:832-768-5370
Mailing Address - Fax:
Practice Address - Street 1:23374 W YUMA RD
Practice Address - Street 2:SUITE 102
Practice Address - City:BUCKEYE
Practice Address - State:AZ
Practice Address - Zip Code:85326-3118
Practice Address - Country:US
Practice Address - Phone:623-738-6812
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-04
Last Update Date:2022-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ45082207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric MedicineGroup - Single Specialty