Physician Compare National (NPI:1881659589)

HEALTHCARE PROVIDER: AREZU DAFTARIAN M.D.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1881659589
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	2668365446
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20040205000348
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	DAFTARIAN
	Individual professional last name
Provider First Name	AREZU
	Individual professional first name
Provider Gender	F
	The provider's gender if the provider is a person.
Provider Credential Text	MD
	The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.

Medical School Information
Medical School Name	TEXAS A & M UNIVERSITY SYSTEM, HSC, COLLEGE OF MEDICINE
	Individual professional's medical school
Graduation Year	1997
	Individual professional's medical school graduation year
Primary Specialty	FAMILY MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	EMERGENCY MEDICINE
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	EMERGENCY MEDICINE
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Line 1 Street Address	2710 OSLER BLVD
	Group Practice or individual's line 1 address
City	BRYAN
	Group Practice or individual's city
State	TX
	Group Practice or individual's state
Zip Code	778022517
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	450011
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	CHI ST JOSEPH HEALTH
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	M