Provider Demographics
NPI:1437383080
Name:KURESHI, FARAZ (MD, MSC)
Entity Type:Individual
Prefix:
First Name:FARAZ
Middle Name:
Last Name:KURESHI
Suffix:
Gender:M
Credentials:MD, MSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4871 WILLIAMS DRIVE
Mailing Address - Street 2:BUILDING 1, SUITE 105
Mailing Address - City:GEORGETOWN
Mailing Address - State:TX
Mailing Address - Zip Code:78633
Mailing Address - Country:US
Mailing Address - Phone:512-240-5025
Mailing Address - Fax:833-913-2545
Practice Address - Street 1:4871 WILLIAMS DRIVE
Practice Address - Street 2:BUILDING 1, SUITE 105
Practice Address - City:GEORGETOWN
Practice Address - State:TX
Practice Address - Zip Code:78633
Practice Address - Country:US
Practice Address - Phone:512-240-5025
Practice Address - Fax:833-913-2545
Is Sole Proprietor?:No
Enumeration Date:2009-05-12
Last Update Date:2022-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD83853207RC0000X
MO2012027922207RC0000X
FLME152207207RC0000X
CAA170624207RC0000X
TXR7795207RC0000X, 207RC0000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program