Provider Demographics
NPI:1316607823
Name:HEERJI, RAFIA
Entity type:Individual
Prefix:
First Name:RAFIA
Middle Name:
Last Name:HEERJI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10950 N CENTRAL EXPY
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-1006
Mailing Address - Country:US
Mailing Address - Phone:972-740-2228
Mailing Address - Fax:
Practice Address - Street 1:1040 RIVER ROCK WAY
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75010-1213
Practice Address - Country:US
Practice Address - Phone:972-740-2228
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-23
Last Update Date:2021-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXA-3371077OtherNBC-HWC