Healthcare Provider Details

I. General information

NPI: 1790693489
Provider Name (Legal Business Name): SUMAIYA ABDULLAH FAROOQ PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 ALLIED DR
PLANO TX
75093-5348
US

IV. Provider business mailing address

6400 INDEPENDENCE PKWY
PLANO TX
75023-4001
US

V. Phone/Fax

Practice location:
  • Phone: 469-814-3278
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: