Provider Demographics
NPI:1154323152
Name:EL-SISSY, FAYZA ABDEL-REHEIM (MD)
Entity Type:Individual
Prefix:DR
First Name:FAYZA
Middle Name:ABDEL-REHEIM
Last Name:EL-SISSY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 10400
Mailing Address - Street 2:
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76547
Mailing Address - Country:US
Mailing Address - Phone:254-245-9045
Mailing Address - Fax:254-245-9284
Practice Address - Street 1:2201 S CLEAR CREEK RD
Practice Address - Street 2:
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76549-4110
Practice Address - Country:US
Practice Address - Phone:254-245-9045
Practice Address - Fax:254-245-9284
Is Sole Proprietor?:No
Enumeration Date:2005-08-10
Last Update Date:2016-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG2891207ZP0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0105XAllopathic & Osteopathic PhysiciansPathologyClinical Pathology/Laboratory Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX83P581OtherBCBS OF TEXAS
TN98388OtherSCOTT AND WHITE INSURANCE
TX220026704OtherMEDICARE RAILRAOD
TX103906702OtherSUPERIOR CHIP PROGRAM
TX103906702Medicaid
G85821Medicare UPIN
TX83P581Medicare PIN