Provider Demographics
NPI:1669087698
Name:MOON, FATIMA ZAHRA (PA-C)
Entity type:Individual
Prefix:
First Name:FATIMA
Middle Name:ZAHRA
Last Name:MOON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8500 QUINTON POINT DR
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75025-7004
Mailing Address - Country:US
Mailing Address - Phone:469-835-8560
Mailing Address - Fax:
Practice Address - Street 1:5899 PRESTON RD STE 1303
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-9595
Practice Address - Country:US
Practice Address - Phone:972-905-9226
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-15
Last Update Date:2020-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical