Provider Demographics
NPI:1326580804
Name:FAHAD OMAR MD PA
Entity Type:Organization
Organization Name:FAHAD OMAR MD PA
Other - Org Name:PULMONARY, SLEEP & ALLERGY CONSULTANTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/ PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:FAHAD
Authorized Official - Middle Name:
Authorized Official - Last Name:OMAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:915-213-0900
Mailing Address - Street 1:1512 N ZARAGOZA RD STE B
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79936-8903
Mailing Address - Country:US
Mailing Address - Phone:915-213-0900
Mailing Address - Fax:915-271-4145
Practice Address - Street 1:2000 TRANS MOUNTAIN RD
Practice Address - Street 2:SUITE 270
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79911-3601
Practice Address - Country:US
Practice Address - Phone:915-213-0900
Practice Address - Fax:915-271-4145
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-15
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207RA0201X, 207RC0200X
TXR0293207RP1001X, 207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
No207RA0201XAllopathic & Osteopathic PhysiciansInternal MedicineAllergy & ImmunologyGroup - Multi-Specialty
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care MedicineGroup - Multi-Specialty
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep MedicineGroup - Multi-Specialty