Provider Demographics
NPI:1417927393
Name:IFTIKHAR, FAIZAN (MD)
Entity Type:Individual
Prefix:DR
First Name:FAIZAN
Middle Name:
Last Name:IFTIKHAR
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:PO BOX 250709
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75025-0709
Mailing Address - Country:US
Mailing Address - Phone:214-544-3355
Mailing Address - Fax:972-547-6250
Practice Address - Street 1:2517 VIRGINIA PKWY
Practice Address - Street 2:SUITE 101
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75071-5077
Practice Address - Country:US
Practice Address - Phone:214-544-3355
Practice Address - Fax:972-547-6250
Is Sole Proprietor?:No
Enumeration Date:2006-01-24
Last Update Date:2011-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL8740174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00919WMedicare PIN
TXG79662Medicare UPIN