Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | K9784 | TX |
N | 2080P0208X | Pediatric Infectious Diseases | K9784 | TX |
NPI | 1336198308 |
---|---|
Provider Name | Dr. Faryal Abdul Ghaffar |
First Address | Grapevine, TX 76051-5543 |
Second Address | Grapevine, TX 76051-5543 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/05/2006 |
Last Update Date | 20/05/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100431903 | (05) | TX |
175070502 | (05) | TX |
8S3300 | BLUE SHIELD (01) | TX |
H21323 | (02) |