=====================================================
General NPI Number Information
=====================================================
NPI Number | 1033190798
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | HUJEFA YUSUF VORA M.D.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/09/2005
-----------------------------------------------------
Last Update Date | 07/11/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3150 MATLOCK RD SUITE 403
-----------------------------------------------------
City | ARLINGTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 76015-2992
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 817-784-0052
-----------------------------------------------------
Fax | 817-375-5800
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3600 CURT DR
-----------------------------------------------------
City | ARLINGTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 76016-3101
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 817-451-5352
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207R00000X
-----------------------------------------------------
Taxonomy Name | Internal Medicine Physician
-----------------------------------------------------
License Number | L4159
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------