Provider Demographics
NPI:1821227471
Name:OMAR, FAHAD (MD)
Entity Type:Individual
Prefix:MR
First Name:FAHAD
Middle Name:
Last Name:OMAR
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 1:1512 N ZARAGOZA RD STE B
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79936-8903
Mailing Address - Country:US
Mailing Address - Phone:915-213-0900
Mailing Address - Fax:915-271-4145
Practice Address - Street 1:2000. B TRANSMOUNTAIN RD
Practice Address - Street 2:SUITE 270
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79911-3600
Practice Address - Country:US
Practice Address - Phone:915-213-0900
Practice Address - Fax:915-351-6601
Is Sole Proprietor?:No
Enumeration Date:2009-07-03
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR0293207R00000X, 207RA0201X, 207RC0200X, 207RS0012X, 207RP1001X
IL036130984207R00000X
MI4301095161207R00000X, 207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RA0201XAllopathic & Osteopathic PhysiciansInternal MedicineAllergy & Immunology
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine