Provider Demographics
NPI:1194024414
Name:HADIDI, OMAR FAYEZ (MD)
Entity Type:Individual
Prefix:
First Name:OMAR
Middle Name:FAYEZ
Last Name:HADIDI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4301 GARTH RD STE 101
Mailing Address - Street 2:
Mailing Address - City:BAYTOWN
Mailing Address - State:TX
Mailing Address - Zip Code:77521-3157
Mailing Address - Country:US
Mailing Address - Phone:281-422-3364
Mailing Address - Fax:281-422-6864
Practice Address - Street 1:4301 GARTH RD STE 101
Practice Address - Street 2:
Practice Address - City:BAYTOWN
Practice Address - State:TX
Practice Address - Zip Code:77521
Practice Address - Country:US
Practice Address - Phone:281-422-3364
Practice Address - Fax:281-422-6864
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-25
Last Update Date:2018-08-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXP9583207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease