Provider Demographics
NPI:1669435996
Name:AHMED, FAYYAZ (MD)
Entity type:Individual
Prefix:DR
First Name:FAYYAZ
Middle Name:
Last Name:AHMED
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 1:11511 SHADOW CREEK PKWY
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-7298
Mailing Address - Country:US
Mailing Address - Phone:713-442-0000
Mailing Address - Fax:
Practice Address - Street 1:2727 W HOLCOMBE BLVD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77025-1669
Practice Address - Country:US
Practice Address - Phone:713-442-0000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-08
Last Update Date:2023-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL0740207R00000X, 207RG0300X, 207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX142190114Medicaid
TX142190113Medicaid
TX142190115Medicaid
TX7999149OtherAETNA
TXP00887769OtherRAILROAD MEDICARE
TX8CG833OtherBCBS
TX142190108Medicaid
TX142190104Medicaid
TX142190105Medicaid
TX142190106Medicaid
TXTXB143857Medicare PIN
TX142190104Medicaid
TX142190105Medicaid
TXTXB143854Medicare PIN
TXH22944Medicare UPIN
TX142190108Medicaid