MEDICARE: AHMAD FAROOQ MD

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	207R00000X	Internal Medicine Physician	0000000000000	ZZ
2	207R00000X	Internal Medicine Physician	S1091	TX
3	207RG0100X	Gastroenterology Physician	S1091	TX

General Provider Information

NPI Number	:	1114269305
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AHMAD FAROOQ MD

Provider Business Mailing Address
First Line	:	1315 ST JOSEPH PKWY STE 1210
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77002-8236
Country	:	US
Telephone Number	:	713-393-7744
Fax Number	:

Provider Business Practice Location Address
First Line	:	1315 ST JOSEPH PKWY STE 1210
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77002-8236
Country	:	US
Telephone Number	:	713-393-7744
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/26/2013
Last Update Date	:	11/05/2024

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