Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204F00000X | Transplant Surgeon | 10521685-1205 | UT |
N | 208200000X | Surgeon | 57.008375 | OH |
N | 208600000X | Surgeon | 57.008375 | OH |
N | 208200000X | Surgeon | P1688 | TX |
N | 208600000X | Surgeon | P1688 | TX |
NPI | 1265622138 |
---|---|
Provider Name | Dr. George Rofaiel |
First Address | Fort Worth, TX 76104-3029 |
Second Address | Fort Worth, TX 76104-3932 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/07/2007 |
Last Update Date | 16/11/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
310060402 | (05) | TX |