Provider Demographics
NPI:1215336110
Name:DADA, FARAH (PA-C)
Entity type:Individual
Prefix:
First Name:FARAH
Middle Name:
Last Name:DADA
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:4461 COIT RD
Mailing Address - Street 2:SUITE 220
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75035-0521
Mailing Address - Country:US
Mailing Address - Phone:972-377-9200
Mailing Address - Fax:972-377-9300
Practice Address - Street 1:7150 PRESTON RD
Practice Address - Street 2:SUITE 300
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-3279
Practice Address - Country:US
Practice Address - Phone:972-705-9599
Practice Address - Fax:972-705-9590
Is Sole Proprietor?:No
Enumeration Date:2014-08-15
Last Update Date:2015-01-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXPA09353363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
381582YM5CMedicare PIN