Provider Demographics
NPI:1356375349
Name:SHARAFPOUR, FARROKH (DC)
Entity type:Individual
Prefix:DR
First Name:FARROKH
Middle Name:
Last Name:SHARAFPOUR
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15615 COIT RD
Mailing Address - Street 2:SUITE 244
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75248-7629
Mailing Address - Country:US
Mailing Address - Phone:972-503-2273
Mailing Address - Fax:972-503-0336
Practice Address - Street 1:15615 COIT RD
Practice Address - Street 2:SUITE 244
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75248-7629
Practice Address - Country:US
Practice Address - Phone:972-503-2273
Practice Address - Fax:972-503-0336
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-10
Last Update Date:2008-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7222111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8U8910OtherBLUE CROSS BLUE SHIELD TX
TX8U8910OtherBLUE CROSS BLUE SHIELD TX
TX8F3825Medicare PIN