Provider Demographics
NPI:1902185853
Name:ATEF MEDICAL PLLC
Entity Type:Organization
Organization Name:ATEF MEDICAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALIREZA
Authorized Official - Middle Name:
Authorized Official - Last Name:ATEF
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-358-0778
Mailing Address - Street 1:811 FARMERS MARKET WAY
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75201-8473
Mailing Address - Country:US
Mailing Address - Phone:214-586-0778
Mailing Address - Fax:
Practice Address - Street 1:2603 OAK LAWN AVE
Practice Address - Street 2:SUITE 101A
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75219
Practice Address - Country:US
Practice Address - Phone:214-586-0778
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-10
Last Update Date:2013-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM5617207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB156904Medicare PIN