Provider Demographics
NPI:1780176255
Name:FARHAN, DAHUD JAMAL (MD)
Entity type:Individual
Prefix:
First Name:DAHUD
Middle Name:JAMAL
Last Name:FARHAN
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 1:502 S CLOSNER BLVD
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78539-4660
Mailing Address - Country:US
Mailing Address - Phone:956-292-0100
Mailing Address - Fax:956-468-2997
Practice Address - Street 1:5416 S JACKSON RD
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-8326
Practice Address - Country:US
Practice Address - Phone:956-213-0040
Practice Address - Fax:956-383-1906
Is Sole Proprietor?:No
Enumeration Date:2018-05-31
Last Update Date:2023-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXU6234207Q00000X
MI4351032040207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXU6234OtherTEXAS MEDICAL BOARD