Nada Amr Fawzi, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

40489 Issued in TX

Practice address

715 Old Austin Hwy Ste 400
Bastrop, TX 78602-5165

Phone

(512) 212-9803

NPI assigned

Jun 19, 2024

Last updated

Jul 1, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Bastrop Modern Dentistry,PC

  dba Bastrop Modern Dentistry

  • Dentist
  • Bastrop, TX
  • NPI 1093252611
  NPD (past)
• Centex Oral Surgery PLLC

  • Oral and Maxillofacial Surgery Clinic/Center
  • Round Rock, TX
  • NPI 1922738913
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1718755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719792000000",
    "number": "1174367841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "421 W 3RD ST APT 601",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787014164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 OLD AUSTIN HWY STE 400",
            "city": "BASTROP",
            "state": "TX",
            "postal_code": "786025165",
            "telephone_number": "512-212-9803"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15424 Fm 1825 Ste 120",
            "address_purpose": "LOCATION",
            "city": "Pflugerville",
            "state": "TX",
            "postal_code": "786603148",
            "country_code": "US",
            "telephone_number": "512-595-7452",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FAWZI",
        "first_name": "NADA",
        "middle_name": "AMR",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-19",
        "last_updated": "2024-07-01",
        "certification_date": "2024-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "40489",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Family Health Center of Bastrop PLLC
• Alyssa Nicole Fanella, PA-C
• Susan Lynn Farris, LCSW
• Fast Track Urgent Care (Fast Aid Urgent Care)
• Fast Track Urgent Care - Bastrop (Fast Aid Urgent Care - Bastrop)
• Fayette Medical Supply, Inc.
• Michael Feller
• Joann R Felter, CNM
• Charles Edgar Ferguson
• Terra L Ferguson, LMSW

• General Practice Dentistry in Bastrop, TX
• Providers in Bastrop, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.