Provider Demographics
NPI:1912387069
Name:RAFI, FARHAN (MD)
Entity Type:Individual
Prefix:
First Name:FARHAN
Middle Name:
Last Name:RAFI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:370 S STATE HIGHWAY 121 N
Mailing Address - Street 2:
Mailing Address - City:COPPELL
Mailing Address - State:TX
Mailing Address - Zip Code:75019-3987
Mailing Address - Country:US
Mailing Address - Phone:214-310-3302
Mailing Address - Fax:855-592-2117
Practice Address - Street 1:370 S STATE HIGHWAY 121 N
Practice Address - Street 2:
Practice Address - City:COPPELL
Practice Address - State:TX
Practice Address - Zip Code:75019-3987
Practice Address - Country:US
Practice Address - Phone:972-382-5761
Practice Address - Fax:855-592-2117
Is Sole Proprietor?:No
Enumeration Date:2015-06-04
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS4046207Q00000X
MI4301107716207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine