Provider Demographics
NPI:1689109126
Name:GHAFOOR, ADIL (MD)
Entity type:Individual
Prefix:DR
First Name:ADIL
Middle Name:
Last Name:GHAFOOR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:950 E STATE HIGHWAY 114 STE 200
Mailing Address - Street 2:
Mailing Address - City:SOUTHLAKE
Mailing Address - State:TX
Mailing Address - Zip Code:76092-5261
Mailing Address - Country:US
Mailing Address - Phone:214-424-2200
Mailing Address - Fax:214-231-2159
Practice Address - Street 1:3144 HORIZON RD STE 210
Practice Address - Street 2:
Practice Address - City:ROCKWALL
Practice Address - State:TX
Practice Address - Zip Code:75032-7047
Practice Address - Country:US
Practice Address - Phone:972-771-2222
Practice Address - Fax:972-771-3350
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-21
Last Update Date:2025-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI76978207R00000X, 207RG0100X
WAMD61064581207RG0100X
TXW0165207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA90735OtherGEORGIA MEDICAL LICENSE