Provider Demographics
NPI:1720069941
Name:FARHOOD, ANWAR (MD)
Entity Type:Individual
Prefix:
First Name:ANWAR
Middle Name:
Last Name:FARHOOD
Suffix:
Gender:M
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:PO BOX 164106
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78716-4106
Mailing Address - Country:US
Mailing Address - Phone:512-324-7516
Mailing Address - Fax:512-324-7536
Practice Address - Street 1:601 E 15TH ST
Practice Address - Street 2:DEPARTMENT OF PATHOLOGY
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78701-1930
Practice Address - Country:US
Practice Address - Phone:512-324-7516
Practice Address - Fax:512-324-7536
Is Sole Proprietor?:No
Enumeration Date:2005-11-07
Last Update Date:2009-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH5548207ZP0102X
MA51573207ZP0102X
PAMD038390E207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX136995112Medicaid
TX136995110Medicaid
TX136995113OtherCSHCN
8K6431OtherBCBS OF TEXAS
TX136995111OtherCSHCN
TX136995114Medicaid
TXP00115579Medicare PIN
8K6431OtherBCBS OF TEXAS
TX136995110Medicaid
TX136995114Medicaid
TX8K6431Medicare PIN
TX8L5687Medicare PIN