Provider Demographics
NPI:1710865621
Name:FARAHANI, ATHENA
Entity type:Individual
Prefix:
First Name:ATHENA
Middle Name:
Last Name:FARAHANI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4201 CYPRESS CREEK PKWY STE 565
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77068-3498
Mailing Address - Country:US
Mailing Address - Phone:832-680-6084
Mailing Address - Fax:
Practice Address - Street 1:4201 CYPRESS CREEK PKWY STE 565
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77068-3498
Practice Address - Country:US
Practice Address - Phone:832-680-6084
Practice Address - Fax:832-747-7552
Is Sole Proprietor?:No
Enumeration Date:2025-08-27
Last Update Date:2025-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1041069225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist