Individual
DR. FARYAL ABDUL GHAFFAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1120 S MAIN ST, SUITE 100, GRAPEVINE, TX 76051-5543
(817) 416-5554
(817) 416-5556
Mailing address
1120 S MAIN ST, SUITE 100, GRAPEVINE, TX 76051-5543
(817) 416-5554
(817) 416-5556
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
K9784
TX
2080P0208X
Pediatric Infectious Diseases Physician
K9784
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100431903
—
TX
05
—
175070502
—
TX
01
—
8S3300
BLUE SHIELD
TX
Enumeration date
05/08/2006
Last updated
05/20/2016
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