Provider Demographics
NPI:1306561238
Name:FAIZA MEMON, MD PLLC
Entity type:Organization
Organization Name:FAIZA MEMON, MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FAIZA
Authorized Official - Middle Name:
Authorized Official - Last Name:MEMON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:615-373-5205
Mailing Address - Street 1:5123 VIRGINIA WAY STE C11
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-7557
Mailing Address - Country:US
Mailing Address - Phone:615-373-5205
Mailing Address - Fax:615-373-5165
Practice Address - Street 1:5123 VIRGINIA WAY STE C11
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-7557
Practice Address - Country:US
Practice Address - Phone:615-373-5205
Practice Address - Fax:615-373-5165
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-04
Last Update Date:2022-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health