MEDICARE: ABDULLAH ALJAAFARI OD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	11391TG	TX

General Provider Information

NPI Number	:	1093601999
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ABDULLAH ALJAAFARI OD

Provider Business Mailing Address
First Line	:	2680 GEORGE DIETER DR
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79936-3202
Country	:	US
Telephone Number	:	915-315-2854
Fax Number	:

Provider Business Practice Location Address
First Line	:	2680 GEORGE DIETER DR
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79936-3202
Country	:	US
Telephone Number	:	915-315-2854
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/16/2025
Last Update Date	:	06/16/2025

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