MEDICARE: DENTON INTERNIST

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician		TX

General Provider Information

NPI Number	:	1821340852
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DENTON INTERNIST

Provider Business Mailing Address
First Line	:	PO BOX 52159
Second Line	:
City	:	DENTON
State	:	TX
Zip	:	76206-2159
Country	:	US
Telephone Number	:	940-591-8800
Fax Number	:	940-591-0700

Provider Business Practice Location Address
First Line	:	2220 SAN JACINTO BLVD
Second Line	:	SUITE 310
City	:	DENTON
State	:	TX
Zip	:	76205-7589
Country	:	US
Telephone Number	:	940-591-8800
Fax Number	:	940-591-0700

Authorized Official
Title or Position	:	CEO/CHAIRMAN
Name	:	DR. RAZA A JAFRY
Credential	:	M.D.
Telephone Number	:	940-591-8800

Provider Enumeration Date	:	10/15/2012
Last Update Date	:	10/18/2013

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Directions to “DENTON INTERNIST ” Practice Location

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