Provider Demographics
NPI:1700232493
Name:FARHAD, NISHATH ALIMAN (DO)
Entity Type:Individual
Prefix:
First Name:NISHATH
Middle Name:ALIMAN
Last Name:FARHAD
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:NISHATH
Other - Middle Name:ALIMAN
Other - Last Name:AHMED
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:821 LOTUS DR
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75081-5197
Mailing Address - Country:US
Mailing Address - Phone:713-392-6180
Mailing Address - Fax:
Practice Address - Street 1:1901 SW H K DODGEN LOOP
Practice Address - Street 2:
Practice Address - City:TEMPLE
Practice Address - State:TX
Practice Address - Zip Code:76502-1814
Practice Address - Country:US
Practice Address - Phone:254-935-5063
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-11
Last Update Date:2016-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP10057595208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics