Provider Demographics
NPI:1811997596
Name:ELHAJJ, FERAS N (MD)
Entity type:Individual
Prefix:
First Name:FERAS
Middle Name:N
Last Name:ELHAJJ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6912 FM 1488 RD SUITE A
Mailing Address - Street 2:
Mailing Address - City:MAGNOLIA
Mailing Address - State:TX
Mailing Address - Zip Code:77354-4520
Mailing Address - Country:US
Mailing Address - Phone:281-356-1945
Mailing Address - Fax:281-356-1978
Practice Address - Street 1:6912 FM 1488 RD STE A
Practice Address - Street 2:
Practice Address - City:MAGNOLIA
Practice Address - State:TX
Practice Address - Zip Code:77354-1527
Practice Address - Country:US
Practice Address - Phone:281-356-1945
Practice Address - Fax:281-356-1978
Is Sole Proprietor?:No
Enumeration Date:2005-07-26
Last Update Date:2014-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL5197207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXH74067Medicare UPIN
TX00Z971Medicare PIN