Provider Demographics
NPI:1356502272
Name:FATIMA, ASMA (MD)
Entity type:Individual
Prefix:DR
First Name:ASMA
Middle Name:
Last Name:FATIMA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 W MAGNOLIA AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76104-7657
Mailing Address - Country:US
Mailing Address - Phone:817-702-2197
Mailing Address - Fax:817-702-2140
Practice Address - Street 1:1400 S MAIN ST STE 401
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76104-4913
Practice Address - Country:US
Practice Address - Phone:817-702-1100
Practice Address - Fax:817-702-2779
Is Sole Proprietor?:No
Enumeration Date:2008-06-23
Last Update Date:2024-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125-053943207R00000X
TXP1071207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine