Provider Demographics
NPI:1902017494
Name:RAHEELA HAFEEZ,M.D., P.A.
Entity type:Organization
Organization Name:RAHEELA HAFEEZ,M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RAHEELA
Authorized Official - Middle Name:
Authorized Official - Last Name:HAFEEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:817-656-1559
Mailing Address - Street 1:5564 LAWNSBERRY DR
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76137-4391
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:817-656-1738
Practice Address - Street 1:855 MONTGOMERY STREET
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76107-2553
Practice Address - Country:US
Practice Address - Phone:817-735-2363
Practice Address - Fax:817-735-2653
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-25
Last Update Date:2008-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK8192208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty