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Individual

MRS. POONEH NICHOL FARAH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
NP-C

Contact information

Practice address
11034 W MILITARY DR STE 101, SAN ANTONIO, TX 78251-1938
(281) 783-8162
Mailing address
5807 CECILYANN, SAN ANTONIO, TX 78253-6410
(210) 325-5849

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
1047555
TX
363LF0000X
Family Nurse Practitioner
1047555
TX
363LP2300X
Primary Care Nurse Practitioner
1047555
TX

Other

Enumeration date
08/18/2021
Last updated
09/13/2022
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