1497738504 NPI number — DR. FAIZUNNISA ANWAR M.D.

Table of content: DR. FAIZUNNISA ANWAR M.D. (NPI 1497738504)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1497738504 NPI number — DR. FAIZUNNISA ANWAR M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ANWAR
Provider First Name:
FAIZUNNISA
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

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:
1497738504
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/26/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1250 CREEK WAY DRIVE
Provider Second Line Business Mailing Address:
SUITE 300
Provider Business Mailing Address City Name:
SUGAR LAND
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77478-4914
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
281-265-1800
Provider Business Mailing Address Fax Number:
281-265-1808

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1250 CREEK WAY DRIVE
Provider Second Line Business Practice Location Address:
SUITE 300
Provider Business Practice Location Address City Name:
SUGAR LAND
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77478-4914
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
281-265-1800
Provider Business Practice Location Address Fax Number:
281-265-1808
Provider Enumeration Date:
11/22/2005

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: 207Q00000X , with the licence number:  L9604 , 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: 173061601 . This is a "MCD TPI - GROUP" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 10033291 . This is a "AMERIGROUP PIN" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 00813Y . This is a "MEDICARE GROUP PIN" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 0012M5 . This is a "BCBSTX GROUP PIN" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 173061602 . This is a "MCD THSTEPS PIN" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 8S3790 . This is a "BCBSTX INDIVIDUAL PIN" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 171030302 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: DD5578 . This is a "MEDICARE RR GROUP PIN" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 5249663 . This is a "CIGNA PIN" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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