Provider Demographics
NPI:1801564240
Name:NAFI, KHADIJA
Entity type:Individual
Prefix:DR
First Name:KHADIJA
Middle Name:
Last Name:NAFI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3809 S GENERAL BRUCE DR STE 103-340
Mailing Address - Street 2:
Mailing Address - City:TEMPLE
Mailing Address - State:TX
Mailing Address - Zip Code:76502-1035
Mailing Address - Country:US
Mailing Address - Phone:805-901-2667
Mailing Address - Fax:
Practice Address - Street 1:1901 VETERANS MEMORIAL DR BLDG 163
Practice Address - Street 2:
Practice Address - City:TEMPLE
Practice Address - State:TX
Practice Address - Zip Code:76504-7451
Practice Address - Country:US
Practice Address - Phone:805-901-2667
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-01
Last Update Date:2021-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX37754122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist