Individual provider Active NPI

Fatima E Jaffer, M.D.

  • Internal Medicine Physician
  • Houston, TX
National Provider Identifier
1184699720
Registry record updated Dec 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
Q2676 Issued in TX
Practice address
12121 Richmond Ave Ste 120
Houston, TX 77082-2420
Phone
(281) 967-5488
NPI assigned
Feb 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 01044403A IN
Internal Medicine Physician 207R00000X 036091346 IL
Internal Medicine Physician 207R00000X Q2676 TX Primary

Addresses

Primary practice location

12121 Richmond Ave Ste 120
Houston, TX 77082-2420

Mailing address

12121 Richmond Ave Ste 120
Houston, TX 77082-2420
Phone (281) 967-5488

Other identifiers 1

IdentifierTypeStateIssuer
200114700BMedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036091346ILMDInternal Medicine Physician
01044403AINMDInternal Medicine Physician
Q2676TXMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1140134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482796800000",
    "number": "1184699720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12121 RICHMOND AVE STE 120",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770822420",
            "telephone_number": "281-967-5488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12121 RICHMOND AVE STE 120",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770822420",
            "telephone_number": "281-967-5488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAFFER",
        "first_name": "FATIMA",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-17",
        "last_updated": "2016-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "01044403A",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036091346",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "Q2676",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200114700B",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2016; 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.