Provider Demographics
NPI:1619378494
Name:SIDDIQI, FARAH HASEEB (MSN, APRN, FNP-C)
Entity type:Individual
Prefix:MRS
First Name:FARAH
Middle Name:HASEEB
Last Name:SIDDIQI
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:326 W HARWOOD RD
Mailing Address - Street 2:APT A
Mailing Address - City:HURST
Mailing Address - State:TX
Mailing Address - Zip Code:76054-3095
Mailing Address - Country:US
Mailing Address - Phone:832-857-7450
Mailing Address - Fax:
Practice Address - Street 1:6401 PRECINCT LINE RD
Practice Address - Street 2:
Practice Address - City:NORTH RICHLAND HILLS
Practice Address - State:TX
Practice Address - Zip Code:76182-4815
Practice Address - Country:US
Practice Address - Phone:817-485-8302
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-11
Last Update Date:2017-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX822622163W00000X
TXAP128818363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse