Provider Demographics
NPI:1558371682
Name:TUFAIL, FAWAD A (MD)
Entity Type:Individual
Prefix:DR
First Name:FAWAD
Middle Name:A
Last Name:TUFAIL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:8080 N CENTRAL EXPY
Mailing Address - Street 2:SUITE 600
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75206-1838
Mailing Address - Country:US
Mailing Address - Phone:972-923-7144
Mailing Address - Fax:972-923-7145
Practice Address - Street 1:1405 W JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:WAXAHACHIE
Practice Address - State:TX
Practice Address - Zip Code:75165-2231
Practice Address - Country:US
Practice Address - Phone:972-923-7144
Practice Address - Fax:972-923-7145
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2022-08-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAMD00043107207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX2888177-04Medicaid
WA8411936Medicaid
WA8804173Medicare ID - Type Unspecified
TX2888177-04Medicaid
WA8411936Medicaid