MEDICARE: AALEYA FARUK KOREISHI MD

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	207WX0120X	Cornea and External Diseases Specialist Physician	M9427	TX
2	207W00000X	Ophthalmology Physician	M9427	TX

General Provider Information

NPI Number	:	1629188073
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AALEYA FARUK KOREISHI MD

Provider Business Mailing Address
First Line	:	801 ROAD TO SIX FLAGS W STE 131
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76012-2600
Country	:	US
Telephone Number	:	817-987-1248
Fax Number	:

Provider Business Practice Location Address
First Line	:	801 ROAD TO SIX FLAGS W STE 131
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76012-2600
Country	:	US
Telephone Number	:	817-987-1248
Fax Number	:

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

Provider Enumeration Date	:	08/30/2006
Last Update Date	:	02/16/2024

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