Provider Demographics
NPI:1144578717
Name:AZEEMUDDIN, FARHEEN (PA-C)
Entity Type:Individual
Prefix:MISS
First Name:FARHEEN
Middle Name:
Last Name:AZEEMUDDIN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7707 FANNIN ST
Mailing Address - Street 2:SUITE 195
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-1926
Mailing Address - Country:US
Mailing Address - Phone:713-797-0045
Mailing Address - Fax:
Practice Address - Street 1:7707 FANNIN
Practice Address - Street 2:SUITE 195
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-1989
Practice Address - Country:US
Practice Address - Phone:713-797-0045
Practice Address - Fax:713-797-1821
Is Sole Proprietor?:No
Enumeration Date:2012-08-29
Last Update Date:2013-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA07769363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical