Provider Demographics
NPI:1972578664
Name:NAQVI, FAUZIA MASOOD (MD)
Entity Type:Individual
Prefix:
First Name:FAUZIA
Middle Name:MASOOD
Last Name:NAQVI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:FAUZIA
Other - Middle Name:MASOOD
Other - Last Name:NAQVI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 660599
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75266-0599
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:802 HOPKINS ST
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75040-7379
Practice Address - Country:US
Practice Address - Phone:214-266-0860
Practice Address - Fax:214-266-0684
Is Sole Proprietor?:No
Enumeration Date:2006-02-17
Last Update Date:2012-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK4510208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX046217803Medicaid
TX8B7799Medicare PIN
TXG73546Medicare UPIN