Provider Demographics
NPI:1427053313
Name:TAIE, FARID FRED (DO)
Entity type:Individual
Prefix:DR
First Name:FARID
Middle Name:FRED
Last Name:TAIE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:428 AMBROSE DR
Mailing Address - Street 2:
Mailing Address - City:MURPHY
Mailing Address - State:TX
Mailing Address - Zip Code:75094-4209
Mailing Address - Country:US
Mailing Address - Phone:972-422-1485
Mailing Address - Fax:972-398-1677
Practice Address - Street 1:1409 SHILOH RD STE 150
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75074-8258
Practice Address - Country:US
Practice Address - Phone:972-398-1665
Practice Address - Fax:972-398-1677
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-16
Last Update Date:2007-10-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXK4813207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8S7890OtherBLUE CROSS AND BLUE SHIEL
TX8S7890OtherBLUE CROSS AND BLUE SHIEL
TXG74388Medicare UPIN