Provider Demographics
NPI:1265546840
Name:KHALFE, WAJIUDDIN (MD)
Entity type:Individual
Prefix:DR
First Name:WAJIUDDIN
Middle Name:
Last Name:KHALFE
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 1:1333 THORNWOOD DR
Mailing Address - Street 2:
Mailing Address - City:MURPHY
Mailing Address - State:TX
Mailing Address - Zip Code:75094-5102
Mailing Address - Country:US
Mailing Address - Phone:972-422-5360
Mailing Address - Fax:972-422-5360
Practice Address - Street 1:6113 JACK FINNEY BLVD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:TX
Practice Address - Zip Code:75402-8085
Practice Address - Country:US
Practice Address - Phone:903-455-7942
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-19
Last Update Date:2010-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK1501207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
G37786Medicare UPIN