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NPI Code Detail

MEDICARE: MRS. NOSHA FARHADFAR M.D.

MEDICARE:  MRS. NOSHA  FARHADFAR  M.D.
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
1207RX0202XMedical Oncology PhysicianME128403FL
2390200000XStudent in an Organized Health Care Education/Training Program39020000XNY
3207RH0003XHematology & Oncology PhysicianU5100TX
4207RH0000XHematology (Internal Medicine) PhysicianME128403FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1760819304
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. NOSHA FARHADFAR M.D.
Provider Business Mailing Address
First Line : 4450 MEDICAL DR FL 1
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78229-3710
Country : US
Telephone Number : 210-575-3817
Fax Number : 210-575-4113
Provider Business Practice Location Address
First Line : 4450 MEDICAL DR FL 1
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78229-3710
Country : US
Telephone Number : 210-575-3817
Fax Number : 210-575-4113
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/27/2013
Last Update Date : 12/14/2023

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Directions to “ MRS. NOSHA FARHADFAR M.D.” Practice Location

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