Provider Demographics
NPI:1659365096
Name:ALAMEDDINE, FADI M (MD)
Entity Type:Individual
Prefix:
First Name:FADI
Middle Name:M
Last Name:ALAMEDDINE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:FADI
Other - Middle Name:F
Other - Last Name:ALAMEDDINE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 3686
Mailing Address - Street 2:DEPT 475
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77253
Mailing Address - Country:US
Mailing Address - Phone:832-688-8400
Mailing Address - Fax:832-688-8430
Practice Address - Street 1:21212 NORTHWEST FWY STE 505
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77429-5888
Practice Address - Country:US
Practice Address - Phone:832-688-8400
Practice Address - Fax:832-688-8430
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-31
Last Update Date:2021-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN0601174400000X, 207RC0000X
FLME 92725207RC0000X, 207RI0011X, 207UN0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No174400000XOther Service ProvidersSpecialist
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL03429OtherBLUE CROSS BLUE SHIELD
TX8BW386OtherBCBS TEXAS ID
TX201582803Medicaid
FL03429OtherBLUE CROSS BLUE SHIELD