Provider Demographics
NPI:1083674485
Name:TARIQ, FARHEEN (MD)
Entity Type:Individual
Prefix:
First Name:FARHEEN
Middle Name:
Last Name:TARIQ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 58688
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:TX
Mailing Address - Zip Code:77598-8688
Mailing Address - Country:US
Mailing Address - Phone:281-724-8336
Mailing Address - Fax:281-336-1619
Practice Address - Street 1:600 N KOBAYASHI STE 308
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:TX
Practice Address - Zip Code:77598-4841
Practice Address - Country:US
Practice Address - Phone:281-724-8336
Practice Address - Fax:281-336-1619
Is Sole Proprietor?:No
Enumeration Date:2006-03-28
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP3591207RI0200X, 207RI0200X
PAMD433853207R00000X
MI4301079502207R00000X
IL036125335207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA2092953OtherHIGHMARK BLUE SHIELD
PA1021867550001Medicaid
PA2916857000OtherINDEPENDENCE BLUE CROSS
MI110F376980OtherBCBSM
MI4797902Medicaid
PA1021867550002Medicaid
PA1021867550001Medicaid
TX276297YQEAMedicare PIN
MI4797902Medicaid