MEDICARE: FARIDA VALLIANI MD P A

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	207R00000X	Internal Medicine Physician	J9413	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1669472205
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FARIDA VALLIANI MD P A

Provider Business Mailing Address
First Line	:	3740 N JOSEY LN
Second Line	:	SUITE 206
City	:	CARROLLTON
State	:	TX
Zip	:	75007-2474
Country	:	US
Telephone Number	:	214-731-0031
Fax Number	:	214-731-0065

Provider Business Practice Location Address
First Line	:	3740 N JOSEY LN
Second Line	:	SUITE 206
City	:	CARROLLTON
State	:	TX
Zip	:	75007-2474
Country	:	US
Telephone Number	:	214-731-0031
Fax Number	:	214-731-0065

Authorized Official
Title or Position	:	OWNER
Name	:	DR. FARIDA FARRUKH VALLIANI
Credential	:	MD
Telephone Number	:	214-731-0031

Provider Enumeration Date	:	07/26/2005
Last Update Date	:	10/12/2011

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Directions to “FARIDA VALLIANI MD P A ” Practice Location

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