Provider Demographics
NPI:1952333262
Name:FAROOQ, OMER (MD)
Entity Type:Individual
Prefix:DR
First Name:OMER
Middle Name:
Last Name:FAROOQ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:8117 PRESTON RD
Mailing Address - Street 2:SUITE 800
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75225-6332
Mailing Address - Country:US
Mailing Address - Phone:214-368-9600
Mailing Address - Fax:214-764-5650
Practice Address - Street 1:2525 E CAMELBACK RD
Practice Address - Street 2:SUITE 1100
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85016-4219
Practice Address - Country:US
Practice Address - Phone:602-778-3600
Practice Address - Fax:602-778-3659
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2013-04-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXL4933207R00000X
PAMD447278207R00000X
NJ25MA09197200207R00000X
SCMD 35163207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXG58519Medicare UPIN