Provider Demographics
NPI:1154362465
Name:KAYFAN, FARSHID D (MD)
Entity type:Individual
Prefix:
First Name:FARSHID
Middle Name:D
Last Name:KAYFAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1717 MAIN ST
Mailing Address - Street 2:SUITE 5300
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75201-4605
Mailing Address - Country:US
Mailing Address - Phone:214-712-2074
Mailing Address - Fax:214-712-2487
Practice Address - Street 1:500 W 4TH ST
Practice Address - Street 2:
Practice Address - City:ODESSA
Practice Address - State:TX
Practice Address - Zip Code:79761-5001
Practice Address - Country:US
Practice Address - Phone:432-640-1190
Practice Address - Fax:432-640-3489
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2010-04-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXJ3828207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX138542919Medicaid
TX138542915Medicaid
TXF35058Medicare UPIN
TX138542919Medicaid
TX8D5483Medicare PIN