Provider Demographics
NPI:1174865810
Name:FAISAL, FARZANA (MD)
Entity Type:Individual
Prefix:
First Name:FARZANA
Middle Name:
Last Name:FAISAL
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 910221
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75391-0221
Mailing Address - Country:US
Mailing Address - Phone:205-197-7700
Mailing Address - Fax:
Practice Address - Street 1:3501 N SCOTTSDALE RD STE 246
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-5630
Practice Address - Country:US
Practice Address - Phone:602-264-0608
Practice Address - Fax:602-234-0417
Is Sole Proprietor?:No
Enumeration Date:2013-03-20
Last Update Date:2022-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ66774208800000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty