Provider Demographics
NPI:1861459927
Name:AFRIDI, IMRAN (MD)
Entity type:Individual
Prefix:DR
First Name:IMRAN
Middle Name:
Last Name:AFRIDI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 797007
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75379-7007
Mailing Address - Country:US
Mailing Address - Phone:214-942-5511
Mailing Address - Fax:214-942-5512
Practice Address - Street 1:916 E HIGHWAY 67
Practice Address - Street 2:
Practice Address - City:DUNCANVILLE
Practice Address - State:TX
Practice Address - Zip Code:75137-2706
Practice Address - Country:US
Practice Address - Phone:214-942-5511
Practice Address - Fax:214-942-5512
Is Sole Proprietor?:No
Enumeration Date:2006-05-01
Last Update Date:2015-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ-2474207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8V5580OtherBCBS
TX105929704Medicaid
TXG37994Medicare UPIN
TX105929704Medicaid