Provider Demographics
NPI:1205393279
Name:FATEMA S UDDIN MD, PLLC
Entity Type:Organization
Organization Name:FATEMA S UDDIN MD, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FATEMA
Authorized Official - Middle Name:S
Authorized Official - Last Name:UDDIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-244-2334
Mailing Address - Street 1:6676 SHADY GLEN CIR
Mailing Address - Street 2:
Mailing Address - City:BENBROOK
Mailing Address - State:TX
Mailing Address - Zip Code:76132-2798
Mailing Address - Country:US
Mailing Address - Phone:214-244-2334
Mailing Address - Fax:
Practice Address - Street 1:601 OMEGA DR STE 201
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76014-2075
Practice Address - Country:US
Practice Address - Phone:214-244-2334
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-26
Last Update Date:2021-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty