Provider Demographics
NPI:1629832761
Name:FARID, NADIN
Entity Type:Individual
Prefix:
First Name:NADIN
Middle Name:
Last Name:FARID
Suffix:
Gender:F
Credentials:
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 57845
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:TX
Mailing Address - Zip Code:77598-7845
Mailing Address - Country:US
Mailing Address - Phone:832-919-6765
Mailing Address - Fax:281-336-9469
Practice Address - Street 1:1917 ASHLAND ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77008-3907
Practice Address - Country:US
Practice Address - Phone:832-919-6765
Practice Address - Fax:281-336-9469
Is Sole Proprietor?:No
Enumeration Date:2024-02-08
Last Update Date:2024-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1014152363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily