Basic Information
| Provider Information | |||||||||
| NPI: | 1881994713 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | JAWAD A QURESHI MD PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 975673 | ||||||||
| Address2: | |||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 753975673 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9727911224 | ||||||||
| FaxNumber: | 9728190050 | ||||||||
| Practice Location | |||||||||
| Address1: | 2321 IRA E WOODS AVE | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | GRAPEVINE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 760518632 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8179756398 | ||||||||
| FaxNumber: | 8177567228 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/26/2010 | ||||||||
| LastUpdateDate: | 02/03/2012 | ||||||||
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| AuthorizedOfficialLastName: | QURESHI | ||||||||
| AuthorizedOfficialFirstName: | JAWAD | ||||||||
| AuthorizedOfficialMiddleName: | A | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 8179756398 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207W00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Ophthalmology |
No ID Information.