1437473378 NPI number — ALAFIA M CHOILAWALA PT

Table of content: ALAFIA M CHOILAWALA PT (NPI 1437473378)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437473378 NPI number — ALAFIA M CHOILAWALA PT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CHOILAWALA
Provider First Name:
ALAFIA
Provider Middle Name:
M
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
RANGWALA
Provider Other First Name:
ALAFIA
Provider Other Middle Name:
M
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
PT
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1437473378
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/22/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
501 S AUSTIN AVE
Provider Second Line Business Mailing Address:
SUITE 1310
Provider Business Mailing Address City Name:
GEORGETOWN
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78626-5637
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
512-864-6054
Provider Business Mailing Address Fax Number:
512-869-8157

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
501 S AUSTIN AVE
Provider Second Line Business Practice Location Address:
SUITE 1310
Provider Business Practice Location Address City Name:
GEORGETOWN
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78626-5637
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
512-864-6054
Provider Business Practice Location Address Fax Number:
512-869-8157
Provider Enumeration Date:
03/22/2010

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , with the licence number:  1159719 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1159719 . This is a "TX STATE BOARD OF PHYSICAL THERAPY" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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