Individual provider Active NPI

Pooneh Nichol Farah, NP-C

  • Nurse Practitioner
  • San Antonio, TX
National Provider Identifier
1891461042
Registry record updated Sep 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
1047555 Issued in TX
Practice address
11034 W Military Dr Ste 101
San Antonio, TX 78251-1938
Phone
(281) 783-8162
NPI assigned
Aug 18, 2021
Last updated
Sep 13, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 13, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 1047555 TX Primary
Family Nurse Practitioner 363LF0000X 1047555 TX
Primary Care Nurse Practitioner 363LP2300X 1047555 TX

Addresses

Primary practice location

11034 W Military Dr Ste 101
San Antonio, TX 78251-1938

Mailing address

5807 Cecilyann
San Antonio, TX 78253-6410
Phone (210) 325-5849

Other practice location 1

5807 Cecilyann
San Antonio, TX 78253-6410
Phone (210) 325-5849

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
I20211228000810 TX Practitioner - Nurse Practitioner 7214328384 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
American Current Care PAGroup PAC ID 9739260019, 545 clinicians

Practice addresses (Care Compare)

12651 Vance Jackson Rd
Suite 114
San Antonio, TX 78230-5960
Phone (210) 762-3780

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1047555TXMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Nluc PLLC CurrentSince Oct 1, 2022 Accepting new patients
Ucp Physicians of Central Texas, PLLC CurrentSince Oct 25, 2021 Accepting new patients
American Current Care, P.a. CurrentSince Feb 24, 2025 Accepting new patients
American Current Care P.a. CurrentSince Feb 24, 2025 Accepting new patients
Nluc PLLC Current Accepting new patients
Texas Healthnet Medical Clinic LTD. Family Medicine CurrentSince Jun 6, 2022 Accepting new patients
Ucp Physicians of Central Texas, PLLC Current Accepting new patients
Nluc PLLC CurrentSince Oct 1, 2022 Accepting new patients

Locations

15810 Midway Rd
Addison, TX 75001
Phone (972) 458-8111

5080 Spectrum Dr
Ste 1200W
Addison, TX 75001

6001 W William Cannon Dr
Ste 302
Austin, TX 78749
Phone (512) 288-3627

1246 N FM 3083 Rd W
Ste B
Conroe, TX 77304

4025 Spid Dr
Corpus Christi, TX 78411
Phone (361) 852-8255

1002 Abc Ave
Ste 600
Freeport, TX 77541
Phone (979) 233-6571

12345 Katy Fwy
Houston, TX 77079
Phone (281) 679-5600

1331 Northpark Dr
Kingwood, TX 77339
Phone (281) 359-5330

1240 E Palm Valley Blvd
Round Rock, TX 78664
Phone (512) 733-9100

11034 W Military Dr
Ste 101
San Antonio, TX 78251

12651 Vance Jackson Rd
Ste 114
San Antonio, TX 78230
Phone (210) 762-3780

5211 FM 2920 Rd
Ste 101
Spring, TX 77388

16312 Southwest Fwy
Ste 18
Sugar Land, TX 77479

Organizations & group practices 8

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": "1629244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663027200000",
    "number": "1891461042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5807 CECILYANN",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782536410",
            "telephone_number": "210-325-5849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11034 W MILITARY DR STE 101",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782511938",
            "telephone_number": "281-783-8162"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5807 Cecilyann",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782536410",
            "country_code": "US",
            "telephone_number": "210-325-5849",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FARAH",
        "first_name": "POONEH",
        "middle_name": "NICHOL",
        "name_prefix": "Mrs.",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-18",
        "last_updated": "2022-09-13",
        "certification_date": "2022-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "1047555",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1047555",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "TX",
            "license": "1047555",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.