MEDICARE: RENAH FARHAN 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	207Q00000X	Family Medicine Physician	4301504983	MI
2	207Q00000X	Family Medicine Physician	U8975	TX

General Provider Information

NPI Number	:	1346800596
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RENAH FARHAN MD

Provider Business Mailing Address
First Line	:	2555 GULF FWY S STE 600
Second Line	:
City	:	LEAGUE CITY
State	:	TX
Zip	:	77573-6742
Country	:	US
Telephone Number	:	281-332-6699
Fax Number	:

Provider Business Practice Location Address
First Line	:	2555 GULF FWY S STE 600
Second Line	:
City	:	LEAGUE CITY
State	:	TX
Zip	:	77573-6742
Country	:	US
Telephone Number	:	281-332-6699
Fax Number	:

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

Provider Enumeration Date	:	06/19/2019
Last Update Date	:	09/16/2024

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