Healthcare Provider Details

I. General information

NPI: 1407089683
Provider Name (Legal Business Name): VFAM PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/03/2009
Last Update Date: 05/21/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2459 E HEBRON PKWY SUITE # 130
CARROLLTON TX
75010-4427
US

IV. Provider business mailing address

2459 E HEBRON PKWY SUITE # 130
CARROLLTON TX
75010-4427
US

V. Phone/Fax

Practice location:
  • Phone: 972-428-7000
  • Fax: 972-395-7119
Mailing address:
  • Phone: 972-428-7000
  • Fax: 972-395-7119

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number
License Number State
# 7
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 8
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberL0446
License Number StateTX

VIII. Authorized Official

Name: DR. FARAH NAZ
Title or Position: CEO
Credential: M D
Phone: 972-395-8600