Basic Information
| Provider Information | |||||||||
| NPI: | 1326580804 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | FAHAD OMAR MD PA | ||||||||
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| OtherOrganizationName: | PULMONARY, SLEEP & ALLERGY CONSULTANTS | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1512 N ZARAGOZA RD STE B | ||||||||
| Address2: | |||||||||
| City: | EL PASO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 799368903 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9152130900 | ||||||||
| FaxNumber: | 9152714145 | ||||||||
| Practice Location | |||||||||
| Address1: | 2000 TRANS MOUNTAIN RD | ||||||||
| Address2: | SUITE 270 | ||||||||
| City: | EL PASO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 799113601 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9152130900 | ||||||||
| FaxNumber: | 9152714145 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/15/2016 | ||||||||
| LastUpdateDate: | 06/18/2019 | ||||||||
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| AuthorizedOfficialLastName: | OMAR | ||||||||
| AuthorizedOfficialFirstName: | FAHAD | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER/ PHYSICIAN | ||||||||
| AuthorizedOfficialTelephone: | 9152130900 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RS0012X | R0293 | TX | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Sleep Medicine | 207RP1001X | R0293 | TX | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease |
No ID Information.