Provider Demographics
NPI:1639631930
Name:MOMIN, FAIZA AMIN (NP)
Entity Type:Individual
Prefix:
First Name:FAIZA
Middle Name:AMIN
Last Name:MOMIN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12030 CAIRNHILL DR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77407-3035
Mailing Address - Country:US
Mailing Address - Phone:310-683-8034
Mailing Address - Fax:
Practice Address - Street 1:7200 CAMBRIDGE ST STE 9B
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-4202
Practice Address - Country:US
Practice Address - Phone:310-683-8034
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-04
Last Update Date:2022-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX892821163W00000X, 363L00000X
TXAP142407363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse