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General NPI Number Information
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NPI Number | 1063538478
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Entity Type | Organization
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Legal Business Name | CHAFTARI MEDICAL INC
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Dates
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Enumeration Date | 03/21/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 119 HOSPITAL DR
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City | OAKDALE
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State | LA
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Zip | 71463-3034
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Country | US
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Telephone | 318-215-0020
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Fax |
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Provider Business Mailing Address
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Address Line | 5119 CHESTNUT ST
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City | BELLAIRE
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State | TX
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Zip | 77401-3317
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Country | US
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Telephone | 713-592-5459
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Fax |
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Authorized Official
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Title or Position | TREASURER CO-OWNER
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Name | DR. PATRICK SAMIR CHAFTARI
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Credential | M.D.
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Telephone | 713-592-5459
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 13244R
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License Number State | LA
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