=====================================================
General NPI Number Information
=====================================================
NPI Number | 1295997930
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ASHFAQ A. TAPIA MD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/25/2008
-----------------------------------------------------
Last Update Date | 08/19/2016
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1800 FARM ROAD 195
-----------------------------------------------------
City | PARIS
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75462-2806
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 903-739-7920
-----------------------------------------------------
Fax | 903-739-7925
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1800 FARM ROAD 195
-----------------------------------------------------
City | PARIS
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75462-2806
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 903-739-7920
-----------------------------------------------------
Fax | 903-739-7925
-----------------------------------------------------
=====================================================
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 | 249216
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207R00000X
-----------------------------------------------------
Taxonomy Name | Internal Medicine Physician
-----------------------------------------------------
License Number | N4787
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------