# MANZOOR TARIQ, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1952555005
- **Authorized official:** DR. MANZOOR A TARIQ M.D. (M.D.)
- **Authorized official phone:** (636) 931-7111

## Contact information

- **Practice address:** 1071 AIRPORT RD, FESTUS, MO 63028-4103
- **Practice address phone:** (636) 931-7111
- **Mailing address:** 1071 AIRPORT RD, FESTUS, MO 63028-4103
- **Mailing address phone:** (636) 931-7111

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LA2200X | Adult Health Nurse Practitioner | 133876 | MO | Yes |

## Other

- **Enumeration date:** 11/14/2008
- **Last updated:** 11/14/2008