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General NPI Number Information
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NPI Number | 1821340852
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Entity Type | Organization
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Legal Business Name | DENTON INTERNIST
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Dates
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Enumeration Date | 10/15/2012
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Last Update Date | 10/18/2013
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Provider Practice Location Address
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Address Line | 2220 SAN JACINTO BLVD SUITE 310
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City | DENTON
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State | TX
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Zip | 76205-7589
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Country | US
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Telephone | 940-591-8800
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Fax | 940-591-0700
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Provider Business Mailing Address
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Address Line | PO BOX 52159
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City | DENTON
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State | TX
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Zip | 76206-2159
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Country | US
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Telephone | 940-591-8800
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Fax | 940-591-0700
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Authorized Official
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Title or Position | CEO/CHAIRMAN
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Name | DR. RAZA A JAFRY
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Credential | M.D.
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Telephone | 940-591-8800
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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 | TX
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