Provider Demographics
NPI:1497903272
Name:HAQ, FASIHA (MD)
Entity Type:Individual
Prefix:
First Name:FASIHA
Middle Name:
Last Name:HAQ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:13912 MORGAN BAY CT
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-3960
Mailing Address - Country:US
Mailing Address - Phone:713-429-5325
Mailing Address - Fax:281-816-5931
Practice Address - Street 1:12234 SHADOW CREEK PKWY
Practice Address - Street 2:BUILDING 4, STE 104
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-7330
Practice Address - Country:US
Practice Address - Phone:713-429-5325
Practice Address - Fax:281-816-5931
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-04
Last Update Date:2015-10-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXP43172084P0800X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX3445751-01Medicaid