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NPI Code Detail

MEDICARE: SHAISTA TARIQ

MEDICARE: SHAISTA TARIQ
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
1225X00000XOccupational Therapist110869TX

General Provider Information

NPI Number : 1124755533
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHAISTA TARIQ
Provider Business Mailing Address
First Line : 4437 BUCHANAN DR
Second Line :
City : PLANO
State : TX
Zip : 75024-7256
Country : US
Telephone Number : 609-214-8423
Fax Number :
Provider Business Practice Location Address
First Line : 4045 W 15TH ST
Second Line :
City : PLANO
State : TX
Zip : 75093-5891
Country : US
Telephone Number : 972-519-0480
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/04/2022
Last Update Date : 08/04/2022

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Directions to “ SHAISTA TARIQ ” Practice Location

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