Provider Demographics
NPI:1780280644
Name:FAROOQI, MARIYA FAHEEM (PHARMD)
Entity type:Individual
Prefix:DR
First Name:MARIYA
Middle Name:FAHEEM
Last Name:FAROOQI
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7916 SWENSON DR
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75063-0148
Mailing Address - Country:US
Mailing Address - Phone:401-486-4729
Mailing Address - Fax:
Practice Address - Street 1:2454 JUPITER RD
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75074-4904
Practice Address - Country:US
Practice Address - Phone:972-578-8607
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-07
Last Update Date:2020-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX57590183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX465824Medicaid