Provider Demographics
NPI:1134126691
Name:HARANDI, SAFOORA (MD)
Entity type:Individual
Prefix:DR
First Name:SAFOORA
Middle Name:
Last Name:HARANDI
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 1:3016 COMMUNICATIONS PKWY STE 100
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-8906
Mailing Address - Country:US
Mailing Address - Phone:972-312-8429
Mailing Address - Fax:972-312-8445
Practice Address - Street 1:3016 COMMUNICATIONS PKWY STE 100
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-8906
Practice Address - Country:US
Practice Address - Phone:972-312-8429
Practice Address - Fax:972-312-8445
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-30
Last Update Date:2024-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK9558207RC0200X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0446031-03Medicaid
TX0020LSOtherBLUE SHIELD
TXH19942Medicare UPIN