Individual provider Active NPI

Humaira Farukh, PA-C

  • Physician Assistant
  • Richmond, TX
National Provider Identifier
1306460316
Registry record updated Jun 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
13903 Carncross CT
Richmond, TX 77407-1007
Phone
(281) 690-0111
NPI assigned
Jun 4, 2020
Last updated
Jun 4, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 4, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X TX Primary

Addresses

Primary practice location

13903 Carncross CT
Richmond, TX 77407-1007

Mailing address

13903 Carncross CT
Richmond, TX 77407-1007
Phone (281) 690-0111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210910000558 TX Practitioner - Physician Assistant 5193121598 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Southlake Doctors Express, PA PSC Single Specialty Current Accepting new patients

Locations

2315 E Southlake Blvd
Ste 110
Southlake, TX 76092
Phone (817) 488-9922

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1591228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591228800000",
    "number": "1306460316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13903 CARNCROSS CT",
            "city": "RICHMOND",
            "state": "TX",
            "postal_code": "774071007",
            "telephone_number": "281-690-0111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13903 CARNCROSS CT",
            "city": "RICHMOND",
            "state": "TX",
            "postal_code": "774071007",
            "telephone_number": "281-690-0111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARUKH",
        "first_name": "HUMAIRA",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-06-04",
        "last_updated": "2020-06-04",
        "certification_date": "2020-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, TX

Sources for this page

Verify at the official NPI Registry.