Provider Demographics
NPI:1134295843
Name:FARHAT, NIAZ (MD)
Entity Type:Individual
Prefix:
First Name:NIAZ
Middle Name:
Last Name:FARHAT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:429 CASCADA DR
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75081-5198
Mailing Address - Country:US
Mailing Address - Phone:888-909-0310
Mailing Address - Fax:888-909-0146
Practice Address - Street 1:1551 HIGHWAY 34 S
Practice Address - Street 2:
Practice Address - City:TERRELL
Practice Address - State:TX
Practice Address - Zip Code:75160-4833
Practice Address - Country:US
Practice Address - Phone:888-909-0310
Practice Address - Fax:888-909-0146
Is Sole Proprietor?:No
Enumeration Date:2006-11-27
Last Update Date:2012-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM6127207R00000X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8J4861Medicare PIN
I31430Medicare UPIN