Basic Information
| Provider Information | |||||||||
| NPI: | 1376137349 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | EL ALFY | ||||||||
| FirstName: | FARH | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5506 POSTWOOD GREEN LN | ||||||||
| Address2: | |||||||||
| City: | SPRING | ||||||||
| State: | TX | ||||||||
| PostalCode: | 773734957 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2816367645 | ||||||||
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| Practice Location | |||||||||
| Address1: | 905 N GULF BLVD | ||||||||
| Address2: | |||||||||
| City: | FREEPORT | ||||||||
| State: | TX | ||||||||
| PostalCode: | 775413907 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2818241490 | ||||||||
| FaxNumber: | 2812206407 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/21/2021 | ||||||||
| LastUpdateDate: | 07/26/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 07/26/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1223G0001X | 37895 | TX | Y | Dental Providers | Dentist | General Practice | 122300000X | 37895 | TX | N | Dental Providers | Dentist | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program |
No ID Information.