1023723046 NPI number — FALIH MOHAMMAD IKRAM CPHT, EMT-B

Table of content: FALIH MOHAMMAD IKRAM CPHT, EMT-B (NPI 1023723046)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1023723046 NPI number — FALIH MOHAMMAD IKRAM CPHT, EMT-B

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
IKRAM
Provider First Name:
FALIH
Provider Middle Name:
MOHAMMAD
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
CPHT, EMT-B
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1023723046
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/16/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
227 AMANDA CT
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MURPHY
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75094-3720
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
480-465-1635
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
115 W FM 544
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MURPHY
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75094-4580
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
972-516-0264
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/16/2023

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 146N00000X , with the licence number:  777663 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 183700000X , with the licence number: 308851 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 777663 . This is a "TEXAS DEPARTMENT OF STATE HEALTH SERVICES" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 308851 . This is a "TEXAS STATE BOARD OF PHARMACY" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 5332-6816-8651 . This is a "NREMT" identifier . This identifiers is of the category "OTHER".
  • Identifier: 30177915 . This is a "PHARMACY TECHNICIAN CERTIFICATION BOARD" identifier . This identifiers is of the category "OTHER".