Provider Demographics
NPI:1629260229
Name:YAQOOB, FEROZ (MD)
Entity Type:Individual
Prefix:
First Name:FEROZ
Middle Name:
Last Name:YAQOOB
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3601 4TH ST
Mailing Address - Street 2:STE 1A122
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79430-8103
Mailing Address - Country:US
Mailing Address - Phone:432-268-7311
Mailing Address - Fax:432-268-7827
Practice Address - Street 1:1901 N US HIGHWAY 87
Practice Address - Street 2:
Practice Address - City:BIG SPRING
Practice Address - State:TX
Practice Address - Zip Code:79720-0283
Practice Address - Country:US
Practice Address - Phone:432-268-7311
Practice Address - Fax:432-268-7827
Is Sole Proprietor?:No
Enumeration Date:2007-08-16
Last Update Date:2017-03-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXN79802084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry