Provider Demographics
NPI:1861676231
Name:NORTH TEXAS FAMILY CLINIC PA
Entity Type:Organization
Organization Name:NORTH TEXAS FAMILY CLINIC PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALI
Authorized Official - Middle Name:
Authorized Official - Last Name:JAFARIAN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:214-398-4690
Mailing Address - Street 1:PO BOX 851888
Mailing Address - Street 2:
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75185-1888
Mailing Address - Country:US
Mailing Address - Phone:972-270-5777
Mailing Address - Fax:972-270-7071
Practice Address - Street 1:2696 N GALLOWAY AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75150-6362
Practice Address - Country:US
Practice Address - Phone:972-613-5500
Practice Address - Fax:972-613-5015
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-20
Last Update Date:2007-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ0016261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0056AZMedicare PIN