Provider Demographics
NPI:1720033624
Name:FAIZUN ANWAR, MD, PA
Entity Type:Organization
Organization Name:FAIZUN ANWAR, MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:HUMA
Authorized Official - Middle Name:
Authorized Official - Last Name:TAHSEEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-265-1800
Mailing Address - Street 1:1250 CREEK WAY DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-3398
Mailing Address - Country:US
Mailing Address - Phone:281-265-1800
Mailing Address - Fax:281-265-1808
Practice Address - Street 1:1250 CREEK WAY DR
Practice Address - Street 2:SUITE 300
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-3398
Practice Address - Country:US
Practice Address - Phone:281-265-1800
Practice Address - Fax:281-265-1808
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-23
Last Update Date:2013-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX10033291OtherAMERIGROUP PIN
TX171030302OtherMCD TPI - INDIVIDUAL
TX173061602OtherEPSDT
TX8F0008OtherMEDICARE PIN - INDIVIDUAL
TX5249663OtherCIGNA PIN
TX0012M5OtherBC/BSTX PIN - GROUP
TX173061601Medicaid
TX8S3790OtherBC/BSTX PIN - INDIVIDUAL
TXDD5578OtherMEDICARE RAILROAD GROUP #
TX173061602OtherEPSDT
TXDD5578OtherMEDICARE RAILROAD GROUP #