| Broadway Elite Medical | |
|
3200 Broadway Blvd Ste 180 Garland TX 75043-1572 | |
| (469) 745-1952 | |
| (469) 745-1953 |
| Full Name | Broadway Elite Medical |
|---|---|
| Speciality | Internal Medicine |
| Location | 3200 Broadway Blvd Ste 180, Garland, Texas |
| Authorized Official Name and Position | Hayan Orfaly (OWNER) |
| Authorized Official Contact | 4697451952 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Broadway Elite Medical 3200 Broadway Blvd Ste 180 Garland TX 75043-1572 Ph: (469) 745-1952 | Broadway Elite Medical 3200 Broadway Blvd Ste 180 Garland TX 75043-1572 Ph: (469) 745-1952 |
| NPI Number | 1013573948 |
|---|---|
| Provider Enumeration Date | 05/16/2019 |
| Last Update Date | 07/08/2019 |
| Medicare PECOS PAC ID | 3274868674 |
|---|---|
| Medicare Enrollment ID | O20190708001232 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013573948 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Hayan A Orfaly |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1396771259 PECOS PAC ID: 1658368345 Enrollment ID: I20080114000510 |
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