MEDICARE: LISA M FARHOOD MD 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	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1619778487
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LISA M FARHOOD MD PLLC

Provider Business Mailing Address
First Line	:	5700 N PORTLAND AVE STE 102
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73112-1650
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5700 N PORTLAND AVE STE 102
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73112-1650
Country	:	US
Telephone Number	:	405-458-7654
Fax Number	:	405-384-7128

Authorized Official
Title or Position	:	PHYSICIAN / OWNER
Name	:	LISA FARHOOD
Credential	:	MD
Telephone Number	:	405-760-3949

Provider Enumeration Date	:	03/19/2025
Last Update Date	:	04/11/2025

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