Basic Information
| Provider Information | |||||||||
| NPI: | 1801250428 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ISHAQUE | ||||||||
| FirstName: | ZUL FARAH | ||||||||
| MiddleName: | S | ||||||||
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| Credential: | M.D. | ||||||||
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| OtherLastName: | ZUL FARAH | ||||||||
| OtherFirstName: | FNU | ||||||||
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| OtherLastNameType: | 5 | ||||||||
| Mailing Information | |||||||||
| Address1: | 1625 MEDICAL CENTER DR | ||||||||
| Address2: | |||||||||
| City: | EL PASO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 799025005 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9155469200 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 515 1ST ST | ||||||||
| Address2: | APT# 336 | ||||||||
| City: | GALVESTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 775505769 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4097303276 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/09/2016 | ||||||||
| LastUpdateDate: | 07/09/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/09/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | S0599 | TX | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.