Provider Demographics
NPI:1811908700
Name:BAKAEEN, FAISAL GHAZI (MD)
Entity type:Individual
Prefix:
First Name:FAISAL
Middle Name:GHAZI
Last Name:BAKAEEN
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 1:2403 N MYSTIC MDW
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77021-2256
Mailing Address - Country:US
Mailing Address - Phone:832-489-3202
Mailing Address - Fax:
Practice Address - Street 1:2002 HOLCOMBE BLVD
Practice Address - Street 2:MICHAEL E. DEBAKEY VA MEDICAL CENTER OCL 112
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-4211
Practice Address - Country:US
Practice Address - Phone:713-794-7892
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2010-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM0008208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX187241801Medicaid
TX8L9038Medicare PIN
H09775Medicare UPIN
TXTXB106030Medicare PIN
8J4824Medicare PIN