Provider Demographics
NPI:1568407344
Name:FIRST AMERICAN MEDICAL
Entity Type:Organization
Organization Name:FIRST AMERICAN MEDICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PRES
Authorized Official - Prefix:MR
Authorized Official - First Name:AMIR
Authorized Official - Middle Name:
Authorized Official - Last Name:RAZA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-245-3635
Mailing Address - Street 1:857 TRISTAR DR
Mailing Address - Street 2:SUITED-1
Mailing Address - City:WEBSTER
Mailing Address - State:TX
Mailing Address - Zip Code:77598-1553
Mailing Address - Country:US
Mailing Address - Phone:713-440-0903
Mailing Address - Fax:713-440-0970
Practice Address - Street 1:857 TRISTAR DR
Practice Address - Street 2:SUITED-1
Practice Address - City:WEBSTER
Practice Address - State:TX
Practice Address - Zip Code:77598-1553
Practice Address - Country:US
Practice Address - Phone:713-440-0903
Practice Address - Fax:713-440-0970
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-17
Last Update Date:2013-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1000239332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0100471-02Medicaid
TX0100471-01Medicaid
TX0860120001Medicare NSC