Healthcare Provider Details

I. General information

NPI: 1134290471
Provider Name (Legal Business Name): ASIM A FAROOQUI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/10/2006
Last Update Date: 02/24/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1515 HERITAGE DR
MCKINNEY TX
75069-6748
US

IV. Provider business mailing address

1515 HERITAGE DR
MCKINNEY TX
75069-3256
US

V. Phone/Fax

Practice location:
  • Phone: 972-422-5939
  • Fax:
Mailing address:
  • Phone: 972-422-5939
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberQ3873
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: