Provider Demographics
NPI:1497812549
Name:FAHEEM, SABAHAT (MD)
Entity Type:Individual
Prefix:
First Name:SABAHAT
Middle Name:
Last Name:FAHEEM
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 1:509 WESTPARK WAY
Mailing Address - Street 2:SUITE 110
Mailing Address - City:EULESS
Mailing Address - State:TX
Mailing Address - Zip Code:76040-3991
Mailing Address - Country:US
Mailing Address - Phone:817-571-3800
Mailing Address - Fax:817-571-3802
Practice Address - Street 1:509 WESTPARK WAY STE 110
Practice Address - Street 2:
Practice Address - City:EULESS
Practice Address - State:TX
Practice Address - Zip Code:76040-3991
Practice Address - Country:US
Practice Address - Phone:817-571-3800
Practice Address - Fax:817-571-3802
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-01
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM57002084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB157026OtherMEDICARE