Provider Demographics
NPI:1891044434
Name:RIZVI, FURQAN (MD)
Entity Type:Individual
Prefix:DR
First Name:FURQAN
Middle Name:
Last Name:RIZVI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:255 W LEBANON STE 224
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75036-3404
Mailing Address - Country:US
Mailing Address - Phone:214-551-7407
Mailing Address - Fax:214-975-2510
Practice Address - Street 1:255 W LEBANON ROAD
Practice Address - Street 2:SUITE 224
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75036-3404
Practice Address - Country:US
Practice Address - Phone:214-551-7407
Practice Address - Fax:214-975-2510
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-29
Last Update Date:2020-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ26112084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX3711772-01Medicaid