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General NPI Number Information
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NPI Number | 1063280972
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Entity Type | Organization
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Legal Business Name | OPTIMAL PRIMARY CARE LLC
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Dates
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Enumeration Date | 12/20/2023
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Last Update Date | 12/20/2023
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Provider Practice Location Address
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Address Line | 225 BELLA KATY DR
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City | KATY
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State | TX
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Zip | 77494-6821
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Country | US
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Telephone | 832-500-7585
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Fax | 832-514-2763
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Provider Business Mailing Address
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Address Line | 225 BELLA KATY DR
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City | KATY
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State | TX
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Zip | 77494-6821
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Country | US
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Telephone | 832-500-7585
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Fax | 832-514-2763
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL/OWNER
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Name | DR. SYED T JAFRI
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Credential | MD
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Telephone | 832-620-4175
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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