Healthcare Provider Details

I. General information

NPI: 1245123710
Provider Name (Legal Business Name): FARIHA FATHIMA NASSAR MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/02/2025
Last Update Date: 06/02/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 CHILDRENS AVENUE A2 14402
OKLAHOMA CITY OK
73104
US

IV. Provider business mailing address

1200 CHILDRENS AVENUE A2 14402
OKLAHOMA CITY OK
73104
US

V. Phone/Fax

Practice location:
  • Phone: 405-271-4417
  • Fax: 405-271-2920
Mailing address:
  • Phone: 405-271-4417
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: