Provider Demographics
NPI:1982999512
Name:GAFUR, OMAR ARIF
Entity Type:Individual
Prefix:DR
First Name:OMAR
Middle Name:ARIF
Last Name:GAFUR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 GILKEY CT
Mailing Address - Street 2:
Mailing Address - City:WATERTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02472-3922
Mailing Address - Country:US
Mailing Address - Phone:512-689-1963
Mailing Address - Fax:
Practice Address - Street 1:1709 DRYDEN RD STE 1700
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2504
Practice Address - Country:US
Practice Address - Phone:713-798-5117
Practice Address - Fax:713-798-6374
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-11
Last Update Date:2015-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP10039716207L00000X
MA261750207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology