Provider Demographics
NPI:1669887295
Name:FARAH, DEEMA J (MD)
Entity type:Individual
Prefix:
First Name:DEEMA
Middle Name:J
Last Name:FARAH
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 1:333 WEST LOOP N STE 250
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-7767
Mailing Address - Country:US
Mailing Address - Phone:713-690-9911
Mailing Address - Fax:713-690-1980
Practice Address - Street 1:333 WEST LOOP N STE 250
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-7767
Practice Address - Country:US
Practice Address - Phone:713-690-1991
Practice Address - Fax:713-690-1980
Is Sole Proprietor?:No
Enumeration Date:2014-06-23
Last Update Date:2021-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2017-01316207Q00000X
390200000X
TXS1023207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program