Provider Demographics
NPI:1023044658
Name:HAQ, FAISAL E (MD)
Entity Type:Individual
Prefix:
First Name:FAISAL
Middle Name:E
Last Name:HAQ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3060 COMMUNICATIONS PKWY
Mailing Address - Street 2:STE 205
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-1629
Mailing Address - Country:US
Mailing Address - Phone:214-754-0000
Mailing Address - Fax:214-379-1849
Practice Address - Street 1:2801 LEMMON AVE STE 400
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75204-2399
Practice Address - Country:US
Practice Address - Phone:214-754-0000
Practice Address - Fax:214-379-1849
Is Sole Proprietor?:No
Enumeration Date:2006-06-24
Last Update Date:2020-09-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXM2637207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX193805201Medicaid
TX193805201Medicaid
TX8G3475Medicare PIN
TX8G3473Medicare PIN
TXP00377139Medicare PIN
TX8G3474Medicare PIN
TXP00620774Medicare PIN