Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 10305 | TX |
N | 111NN1001X | Nutrition | 10305 | TX |
NPI | 1487816815 |
---|---|
Provider Name | Dr. Babush Faridi |
First Address | Houston, TX 77079-1601 |
Second Address | Houston, TX 77079-1601 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/06/2008 |
Last Update Date | 26/06/2008 |