Provider Demographics
NPI:1629055355
Name:ALFAYOUMI, FADI (MD)
Entity Type:Individual
Prefix:
First Name:FADI
Middle Name:
Last Name:ALFAYOUMI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2101 PEASE STREET
Mailing Address - Street 2:STE. 1G
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78550
Mailing Address - Country:US
Mailing Address - Phone:956-698-5613
Mailing Address - Fax:956-389-6567
Practice Address - Street 1:844 CENTRAL BLVD STE 380
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78520-7512
Practice Address - Country:US
Practice Address - Phone:956-698-5613
Practice Address - Fax:956-389-6567
Is Sole Proprietor?:No
Enumeration Date:2005-12-23
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM3448207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1807398-04Medicaid
TX1807398-04Medicaid
TX8L3299Medicare PIN