Healthcare Provider Details

I. General information

NPI: 1750528337
Provider Name (Legal Business Name): DR. KAMRAN ADIL JAFREE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/19/2009
Last Update Date: 08/29/2023
Certification Date: 08/29/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 CLARA BARTON BLVD STE 350
GARLAND TX
75042-5747
US

IV. Provider business mailing address

3170 KETTERING BLVD BLDG B3
MORAINE OH
45439-1924
US

V. Phone/Fax

Practice location:
  • Phone: 972-426-9900
  • Fax: 972-426-9899
Mailing address:
  • Phone: 937-991-3188
  • Fax: 937-223-9811

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License NumberS4503
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: