MEDICARE: FARHEEN MAKANI PMHNP-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	AP135745	TX

General Provider Information

NPI Number	:	1013420595
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FARHEEN MAKANI PMHNP-BC

Provider Business Mailing Address
First Line	:	550 S WATTERS RD STE 246
Second Line	:
City	:	ALLEN
State	:	TX
Zip	:	75013-5230
Country	:	US
Telephone Number	:	469-599-2872
Fax Number	:

Provider Business Practice Location Address
First Line	:	10127 MOROCCO ST STE 113
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78216-3943
Country	:	US
Telephone Number	:	469-599-2872
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/07/2017
Last Update Date	:	05/17/2023

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