Provider Demographics
NPI:1952403958
Name:OSAMA, FAUZIA KHALIDA (MD)
Entity type:Individual
Prefix:DR
First Name:FAUZIA
Middle Name:KHALIDA
Last Name:OSAMA
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 1:2501 ELK TRL
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75025-6022
Mailing Address - Country:US
Mailing Address - Phone:509-910-3775
Mailing Address - Fax:
Practice Address - Street 1:801 A HIGHWAY 78 SUITE 201
Practice Address - Street 2:
Practice Address - City:WYLIE
Practice Address - State:TX
Practice Address - Zip Code:75098
Practice Address - Country:US
Practice Address - Phone:972-325-2285
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2013-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00046131207R00000X
TXP0461207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8457533Medicaid
WAI62341Medicare UPIN
WA8457533Medicaid