Basic Information
Provider Information
NPI: 1700476546
EntityType: 2
ReplacementNPI:  
OrganizationName: SAGUARO PHYSICIANS SERVICES PLLC
LastName:  
FirstName:  
MiddleName:  
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Credential:  
OtherOrganizationName: SAGUARO PHYSICIANS SERVICES PLLC
OtherOrganizationType: 3
OtherLastName:  
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Mailing Information
Address1: 960 RIDGEVIEW DR STE 140-257
Address2:  
City: ALLEN
State: TX
PostalCode: 750135542
CountryCode: US
TelephoneNumber: 2143907697
FaxNumber: 9724326692
Practice Location
Address1: 1320 VELOCE DR
Address2:  
City: PLANO
State: TX
PostalCode: 750740112
CountryCode: US
TelephoneNumber: 9035708709
FaxNumber:  
Other Information
ProviderEnumerationDate: 01/26/2021
LastUpdateDate: 09/27/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
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ProviderGenderCode:  
AuthorizedOfficialLastName: FARHAT
AuthorizedOfficialFirstName: NIAZ
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: OWNER & DIRECTOR
AuthorizedOfficialTelephone: 9035708709
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
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AuthorizedOfficialCredential: MD
NPICertificationDate: 09/27/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207P00000X  Y193200000X MULTI-SPECIALTY GROUPAllopathic & Osteopathic PhysiciansEmergency Medicine 

No ID Information.


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