Organization
FAMILY PRACTICE AND OSTEOPATHIC MEDICINE CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FARID FRED TAIE D.O. (DR.)
(972) 398-1665
Entity
Organization
Contact information
Practice address
1409 SHILOH RD, SUITE 150, PLANO, TX 75074-4332
(972) 398-1665
(972) 398-1677
Mailing address
1409 SHILOH RD, SUITE 150, PLANO, TX 75074-4332
(972) 398-1665
(972) 398-1677
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
K4813
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0087MU
BLUE CROSS AND BLUE SHIEL
TX
Enumeration date
10/30/2007
Last updated
10/30/2007
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