Provider Demographics
NPI:1922265230
Name:FAROOQI, MOHAMMED (PAC)
Entity Type:Individual
Prefix:MR
First Name:MOHAMMED
Middle Name:
Last Name:FAROOQI
Suffix:
Gender:M
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 E NOLANA AVE STE 13A
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-6112
Mailing Address - Country:US
Mailing Address - Phone:956-686-2700
Mailing Address - Fax:956-686-2708
Practice Address - Street 1:2029 A E GRIFFIN PARKWAY
Practice Address - Street 2:
Practice Address - City:MISSION
Practice Address - State:TX
Practice Address - Zip Code:78572
Practice Address - Country:US
Practice Address - Phone:956-424-3222
Practice Address - Fax:956-424-3225
Is Sole Proprietor?:No
Enumeration Date:2008-05-22
Last Update Date:2008-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA03680363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8K8628OtherMEDICARE