Provider Demographics
NPI:1407225386
Name:FAROOQI, SAMINA S (MD)
Entity Type:Individual
Prefix:
First Name:SAMINA
Middle Name:S
Last Name:FAROOQI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:SAMINA
Other - Middle Name:SIYAR
Other - Last Name:FAROOQI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 99213
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76199-0213
Mailing Address - Country:US
Mailing Address - Phone:682-682-1860
Mailing Address - Fax:682-885-1396
Practice Address - Street 1:13340 HIGHLAND HILLS DR STE 111
Practice Address - Street 2:
Practice Address - City:ALEDO
Practice Address - State:TX
Practice Address - Zip Code:76008-2000
Practice Address - Country:US
Practice Address - Phone:682-303-3000
Practice Address - Fax:682-303-3025
Is Sole Proprietor?:No
Enumeration Date:2015-09-21
Last Update Date:2022-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ4096208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics