MEDICARE: FARAHAT AND ASSOCIATES PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RN0300X	Nephrology Physician		TX

General Provider Information

NPI Number	:	1013424860
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FARAHAT AND ASSOCIATES PLLC

Provider Business Mailing Address
First Line	:	10440 N CENTRAL EXPY STE 800
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75231-2264
Country	:	US
Telephone Number	:	469-216-7570
Fax Number	:

Provider Business Practice Location Address
First Line	:	7475 LA VISTA DR APT 1834
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75214-4132
Country	:	US
Telephone Number	:	469-216-7570
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ALA'A FARAHAT
Credential	:	MD
Telephone Number	:	469-216-7570

Provider Enumeration Date	:	01/02/2018
Last Update Date	:	01/02/2018

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