MEDICARE: DR. ASHLEY LOTFABADI DO

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	390200000X	Student in an Organized Health Care Education/Training Program
2	207Q00000X	Family Medicine Physician	7005	OK

General Provider Information

NPI Number	:	1326509712
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ASHLEY LOTFABADI DO

Provider Business Mailing Address
First Line	:	5749 SAN FELIPE ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77057-3101
Country	:	US
Telephone Number	:	888-397-8387
Fax Number	:	281-895-3083

Provider Business Practice Location Address
First Line	:	5749 SAN FELIPE ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77057-3101
Country	:	US
Telephone Number	:	832-579-6200
Fax Number	:	281-895-3083

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

Provider Enumeration Date	:	03/27/2019
Last Update Date	:	05/05/2026

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