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Individual

FARNOUSH F. FAEZ-REZVANI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DPM

Contact information

Practice address
1450 W. GRAND PKWY. S., G-120, KATY, TX 77494-8300
(866) 950-3627
(800) 652-8206
Mailing address
1450 W. GRAND PKWY. S., G-120, KATY, TX 77494-8300
(866) 950-3627
(800) 652-8206

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
1724
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0001MR
BCBS
TX
05
173402201
TX
05
173402202
TX
05
173402203
TX
05
173402205
TX
05
173402206
TX
01
P00452024
RAIL RD. MEDICARE
TX
Enumeration date
05/04/2006
Last updated
04/18/2008
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