Healthcare Provider Details

I. General information

NPI: 1386482529
Provider Name (Legal Business Name): PREVCURE, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/19/2024
Last Update Date: 11/04/2024
Certification Date: 11/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11111 RESEARCH BLVD STE LL2
AUSTIN TX
78759-5200
US

IV. Provider business mailing address

11111 RESEARCH BLVD, STE LL2
AUSTIN TX
78759-5200
US

V. Phone/Fax

Practice location:
  • Phone: 512-334-2665
  • Fax: 512-334-2797
Mailing address:
  • Phone: 512-334-2665
  • Fax: 512-334-2797

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: AHMAD PAIMAN GHAFOORI
Title or Position: PRESIDENT/DOCTOR
Credential: MD
Phone: 512-334-2665