Provider Demographics
NPI:1346800596
Name:FARHAN, RENAH (MD)
Entity type:Individual
Prefix:
First Name:RENAH
Middle Name:
Last Name:FARHAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2555 GULF FWY S STE 600
Mailing Address - Street 2:
Mailing Address - City:LEAGUE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77573-6742
Mailing Address - Country:US
Mailing Address - Phone:281-332-6699
Mailing Address - Fax:
Practice Address - Street 1:2555 GULF FWY S STE 600
Practice Address - Street 2:
Practice Address - City:LEAGUE CITY
Practice Address - State:TX
Practice Address - Zip Code:77573-6742
Practice Address - Country:US
Practice Address - Phone:281-332-6699
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-19
Last Update Date:2024-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301504983207Q00000X
TXU8975207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine