Provider Demographics
NPI:1598797060
Name:KAZI, FAREHA A (MD)
Entity Type:Individual
Prefix:DR
First Name:FAREHA
Middle Name:A
Last Name:KAZI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:FAREHA
Other - Middle Name:ABID
Other - Last Name:KAZI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:8668 JOHN HICKMAN PKWY STE 1003
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-9388
Mailing Address - Country:US
Mailing Address - Phone:214-842-8743
Mailing Address - Fax:214-556-1186
Practice Address - Street 1:8668 JOHN HICKMAN PKWY STE 1003
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034
Practice Address - Country:US
Practice Address - Phone:214-842-8743
Practice Address - Fax:214-556-1186
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2019-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIFK067115207R00000X, 207RN0300X
TXP0985207RN0300X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX302608002Medicaid
110C311580OtherBCN
MI1103307152OtherBCBSM
TX302608002Medicaid
TXTXB146889Medicare PIN
MI1103307152OtherBCBSM
TXTXB146890Medicare PIN