Provider Demographics
NPI:1770552564
Name:CHAUDHRY, AFEEFA (MD)
Entity type:Individual
Prefix:
First Name:AFEEFA
Middle Name:
Last Name:CHAUDHRY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 HOSPITAL PKWY
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76022-6913
Mailing Address - Country:US
Mailing Address - Phone:817-848-2708
Mailing Address - Fax:817-848-4579
Practice Address - Street 1:4001 LONG PRAIRIE RD STE 123
Practice Address - Street 2:
Practice Address - City:FLOWER MOUND
Practice Address - State:TX
Practice Address - Zip Code:75028-1528
Practice Address - Country:US
Practice Address - Phone:469-495-9005
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-15
Last Update Date:2022-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA0776464600207RG0300X
TXM9207207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX195750802Medicaid
NJ0060640Medicaid
NJ088666Medicare PIN
TX195750802Medicaid
TXTXB112344Medicare PIN