Provider Demographics
NPI:1487641718
Name:IBRAHIM, FATIMA (MD)
Entity Type:Individual
Prefix:DR
First Name:FATIMA
Middle Name:
Last Name:IBRAHIM
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 132528
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77393-2528
Mailing Address - Country:US
Mailing Address - Phone:713-876-8407
Mailing Address - Fax:
Practice Address - Street 1:174 S BAUER POINT CIR
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77389-5326
Practice Address - Country:US
Practice Address - Phone:281-586-8800
Practice Address - Fax:827-586-8822
Is Sole Proprietor?:No
Enumeration Date:2005-10-03
Last Update Date:2015-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM17802084N0400X, 207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00106WOtherMHS PHYS OF TX GRP PTAN - HARRIS COUNTY
TX153449704OtherMHS PHYS OF TX MEDICAID GRP TPI - HARRIS COUNTY
TX351187YNBTOtherMDCR PTAN MONTGOMERY CO.
TX351179YNBTOtherMDCR PTAN
TX0035TDOtherMHS PHYS OF TX BCBSTX GRP PROV REC #
TX00659NOtherMHS PHYS OF TX GRP PTAN - MONTGOMERY COUNTY
TX153449706OtherMHS PHYS OF TX MEDICAID GRP TPI - MONTGOMERY COUNTY
TX351187YNBTOtherMDCR PTAN MONTGOMERY CO.
TX8F0941Medicare ID - Type Unspecified