Provider Demographics
NPI:1770583411
Name:FARIZANI, FOROUGH (DO)
Entity type:Individual
Prefix:DR
First Name:FOROUGH
Middle Name:
Last Name:FARIZANI
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6400 HILLCROFT ST STE 100
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77081-3107
Mailing Address - Country:US
Mailing Address - Phone:713-988-3921
Mailing Address - Fax:713-771-8552
Practice Address - Street 1:6400 HILLCROFT ST STE 100
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77081-3107
Practice Address - Country:US
Practice Address - Phone:713-988-3921
Practice Address - Fax:713-771-8552
Is Sole Proprietor?:No
Enumeration Date:2005-07-22
Last Update Date:2025-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK2461207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX081384201Medicaid
TX111758203Medicaid
TX111758201Medicaid
TX081384201Medicaid
TX111758203Medicaid