Provider Demographics
NPI:1942410113
Name:NISHAT, ARIFA (MD)
Entity Type:Individual
Prefix:MRS
First Name:ARIFA
Middle Name:
Last Name:NISHAT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:825 N MCDONALD ST.
Mailing Address - Street 2:SUITE 130
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75069
Mailing Address - Country:US
Mailing Address - Phone:972-548-4764
Mailing Address - Fax:972-548-4441
Practice Address - Street 1:825 N MCDONALD ST.
Practice Address - Street 2:SUITE 130
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75069
Practice Address - Country:US
Practice Address - Phone:972-548-4764
Practice Address - Fax:972-548-4441
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2020-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD203169207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA07811Medicaid