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General NPI Number Information
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NPI Number | 1740613629
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Entity Type | Individual
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Provider Name | FAIDAH O BADRU MD
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Gender | Female
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Dates
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Enumeration Date | 08/15/2013
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Last Update Date | 10/01/2025
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Provider Practice Location Address
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Address Line | 4102 22ND PL
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City | LUBBOCK
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State | TX
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Zip | 79410-1122
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Country | US
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Telephone | 806-725-0237
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Fax | 806-725-1030
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Provider Business Mailing Address
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Address Line | 2215 NASHVILLE AVE
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City | LUBBOCK
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State | TX
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Zip | 79410-1105
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Country | US
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Telephone | 806-725-5228
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Fax | 806-723-6532
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 1828418
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 2086S0120X
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Taxonomy Name | Pediatric Surgery Physician
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License Number | 94191
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License Number State | SC
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Taxonomy #3
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 0101277902
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License Number State | VA
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Taxonomy #4
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 2086S0120X
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Taxonomy Name | Pediatric Surgery Physician
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License Number | W0362
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License Number State | TX
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