Provider Demographics
NPI:1871629485
Name:ATEF-ZAFARMAND, ALIREZA (MD)
Entity type:Individual
Prefix:DR
First Name:ALIREZA
Middle Name:
Last Name:ATEF-ZAFARMAND
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 1:1420 VICEROY DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75235-2208
Mailing Address - Country:US
Mailing Address - Phone:214-358-2300
Mailing Address - Fax:214-366-6127
Practice Address - Street 1:5308 N GALLOWAY AVE
Practice Address - Street 2:STE 200
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75150-1176
Practice Address - Country:US
Practice Address - Phone:214-358-2300
Practice Address - Fax:214-579-6754
Is Sole Proprietor?:No
Enumeration Date:2007-02-26
Last Update Date:2008-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM5617207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX186239301Medicaid
TXP00420781Medicare PIN
TX186239301Medicaid