Provider Demographics
NPI:1720218712
Name:FAROOQUE, NAVEERA (OD)
Entity Type:Individual
Prefix:
First Name:NAVEERA
Middle Name:
Last Name:FAROOQUE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14002 FM 2920 RD STE B
Mailing Address - Street 2:
Mailing Address - City:TOMBALL
Mailing Address - State:TX
Mailing Address - Zip Code:77377-6419
Mailing Address - Country:US
Mailing Address - Phone:281-970-3840
Mailing Address - Fax:281-970-3852
Practice Address - Street 1:14002 FM 2920 RD STE B
Practice Address - Street 2:
Practice Address - City:TOMBALL
Practice Address - State:TX
Practice Address - Zip Code:77377-6419
Practice Address - Country:US
Practice Address - Phone:281-970-3840
Practice Address - Fax:281-970-3852
Is Sole Proprietor?:No
Enumeration Date:2009-07-23
Last Update Date:2021-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7398TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist