Provider Demographics
NPI:1699722199
Name:ASFOURI, SOUHAIL (MD)
Entity type:Individual
Prefix:DR
First Name:SOUHAIL
Middle Name:
Last Name:ASFOURI
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 1:4316 JAMES CASEY ST
Mailing Address - Street 2:BLD F #200
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78745-1109
Mailing Address - Country:US
Mailing Address - Phone:512-444-1811
Mailing Address - Fax:512-444-1812
Practice Address - Street 1:4316 JAMES CASEY ST
Practice Address - Street 2:BLD F #200
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78745-1109
Practice Address - Country:US
Practice Address - Phone:512-444-1811
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-28
Last Update Date:2008-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH8979207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX104961103Medicaid
TX104961103Medicaid
TX00200HMedicare PIN