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General NPI Number Information
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NPI Number | 1538185780
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Entity Type | Individual
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Provider Name | DEYA JACOB DAFASHY M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/14/2006
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Last Update Date | 10/08/2008
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Provider Practice Location Address
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Address Line | 5119 FAIRMONT PKWY STE A
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City | PASADENA
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State | TX
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Zip | 77505-3727
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Country | US
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Telephone | 281-991-7603
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Fax | 281-991-7675
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Provider Business Mailing Address
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Address Line | PO BOX 890827
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City | HOUSTON
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State | TX
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Zip | 77289-0827
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Country | US
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Telephone | 281-991-7603
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Fax | 281-991-7675
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | L1026
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License Number State | TX
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