Provider Demographics
NPI:1497738504
Name:ANWAR, FAIZUNNISA (MD)
Entity Type:Individual
Prefix:DR
First Name:FAIZUNNISA
Middle Name:
Last Name:ANWAR
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 1:1250 CREEK WAY DRIVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-4914
Mailing Address - Country:US
Mailing Address - Phone:281-265-1800
Mailing Address - Fax:281-265-1808
Practice Address - Street 1:1250 CREEK WAY DRIVE
Practice Address - Street 2:SUITE 300
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-4914
Practice Address - Country:US
Practice Address - Phone:281-265-1800
Practice Address - Fax:281-265-1808
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-22
Last Update Date:2009-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL9604207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX173061601OtherMCD TPI - GROUP
TX10033291OtherAMERIGROUP PIN
TX00813YOtherMEDICARE GROUP PIN
TX0012M5OtherBCBSTX GROUP PIN
TX173061602OtherMCD THSTEPS PIN
TX8S3790OtherBCBSTX INDIVIDUAL PIN
TX171030302Medicaid
TXDD5578OtherMEDICARE RR GROUP PIN
TX5249663OtherCIGNA PIN
TX8F0008Medicare ID - Type Unspecified
TX0012M5OtherBCBSTX GROUP PIN