Active NPI
Manzoor S Farooqi, MD
- Pediatrics Physician
- Killeen, TX
National Provider Identifier
1821098534
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- K0741
- Practice address
- 3004 S W S Young Dr
Killeen, TX 76542-2023 - Phone
- (254) 634-7337
- Fax
- (254) 634-2592
- NPI assigned
- Jul 22, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | K0741 | TX | Primary |
Addresses
Primary practice location
3004 S W S Young Dr
Killeen, TX 76542-2023
Mailing address
PO Box 938
Killeen, TX 76540-0938
Phone (254) 634-6999
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 710884482 | Other | TX | HUMANA/MILITARY-TRICARE |
| 0038AC | Other | TX | BCBS OF TEXAS |
| 092090201 | Medicaid | TX | |
| 092090202 | Other | TX | MCD EPSDT |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| K0741 | TX | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Killeen Pediatric Care Clinic, P.a. | Pediatrics | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1121990400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1323820800000",
"number": "1821098534",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 938",
"city": "KILLEEN",
"state": "TX",
"postal_code": "765400938",
"telephone_number": "254-634-6999",
"fax_number": "254-200-4090"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3004 S W S YOUNG DR",
"city": "KILLEEN",
"state": "TX",
"postal_code": "765422023",
"telephone_number": "254-634-7337",
"fax_number": "254-634-2592"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FAROOQI",
"first_name": "MANZOOR",
"middle_name": "S",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-07-22",
"last_updated": "2011-12-14",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "TX",
"license": "K0741",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HUMANA/MILITARY-TRICARE",
"identifier": "710884482",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF TEXAS",
"identifier": "0038AC",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "092090201",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MCD EPSDT",
"identifier": "092090202",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Killeen, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.