Provider Demographics
NPI:1053313247
Name:M. FAWWAZ SHOUKFEH, M.D., P.A.
Entity Type:Organization
Organization Name:M. FAWWAZ SHOUKFEH, M.D., P.A.
Other - Org Name:TEXAS CARDIAC CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:M
Authorized Official - Middle Name:F
Authorized Official - Last Name:SHOUKFEH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:806-780-8003
Mailing Address - Street 1:3710 21ST ST
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79410-1220
Mailing Address - Country:US
Mailing Address - Phone:806-780-8003
Mailing Address - Fax:
Practice Address - Street 1:3710 21ST ST
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79410-1220
Practice Address - Country:US
Practice Address - Phone:806-780-8003
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-01
Last Update Date:2009-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00087NMedicare ID - Type Unspecified