Provider Demographics
NPI:1386750891
Name:FAIZ, ROKHSAREH (DC)
Entity type:Individual
Prefix:
First Name:ROKHSAREH
Middle Name:
Last Name:FAIZ
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:ROXANNE
Other - Middle Name:
Other - Last Name:BAHRANI-FAIZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2600 K AVE #190
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75074
Mailing Address - Country:US
Mailing Address - Phone:214-616-6119
Mailing Address - Fax:972-231-3148
Practice Address - Street 1:2600 K. AVE #190
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75074
Practice Address - Country:US
Practice Address - Phone:214-616-6119
Practice Address - Fax:972-231-3148
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-21
Last Update Date:2014-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9938111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8F2752Medicare PIN