MEDICARE: AFREEN S PAPPA MD

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	207Q00000X	Family Medicine Physician	J4415	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	340731	OTHER	TX	GROUP MEDICARE PTAN
2	340739	OTHER	TX	GROUP MEDICARE PTAN

General Provider Information

NPI Number	:	1457431876
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AFREEN S PAPPA MD

Provider Business Mailing Address
First Line	:	2001 BUTTERFIELD RD
Second Line	:	SUITE 300
City	:	DOWNERS GROVE
State	:	IL
Zip	:	60515-1050
Country	:	US
Telephone Number	:	630-725-2832
Fax Number	:	877-489-5993

Provider Business Practice Location Address
First Line	:	2615 SOUTHWEST FWY
Second Line	:	SUITE 220
City	:	HOUSTON
State	:	TX
Zip	:	77098-4609
Country	:	US
Telephone Number	:	713-527-8731
Fax Number	:	713-527-8731

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

Provider Enumeration Date	:	10/17/2006
Last Update Date	:	06/10/2016

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Directions to “ AFREEN S PAPPA MD” Practice Location

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