Provider Demographics
NPI:1659387413
Name:FAHMY, HANAN (MD, ED M, FASN)
Entity Type:Individual
Prefix:DR
First Name:HANAN
Middle Name:
Last Name:FAHMY
Suffix:
Gender:F
Credentials:MD, ED M, FASN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5018 EMPIRE WAY
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75038-3455
Mailing Address - Country:US
Mailing Address - Phone:217-891-8056
Mailing Address - Fax:
Practice Address - Street 1:2001 N MACARTHUR BLVD STE 335
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75061-2298
Practice Address - Country:US
Practice Address - Phone:214-716-7573
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2021-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN1628207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILF66419Medicare UPIN