Mohammad R Fazel, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

G1003 Issued in TX

Practice address

107 S Ave M
Olney, TX 76374

Phone

(940) 564-3561

Fax

(940) 564-5230

NPI assigned

Feb 9, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1223424000000",
    "number": "1336280767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 458",
            "address_2": "107 S AVE M",
            "city": "OLNEY",
            "state": "TX",
            "postal_code": "76374",
            "telephone_number": "940-564-3561",
            "fax_number": "940-564-5230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 S AVE M",
            "city": "OLNEY",
            "state": "TX",
            "postal_code": "76374",
            "telephone_number": "940-564-3561",
            "fax_number": "940-564-5230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAZEL",
        "first_name": "MOHAMMAD",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-09",
        "last_updated": "2008-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TX",
            "license": "G1003",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "TX",
            "license": "G1003",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "G1003",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "133873301",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brandie Daws, FNP-C
• Tamara Dawn Delacruz
• Irene Downing, PTA
• Shanna Lynn Estridge, LVN
• Faith Community Hospital
• Verma Fobbs, LVN
• GCC Olney, LLC
• Murray Gentry, RPH
• Megan Nicole Hammonds, MSN, APRN, FNP-C
• John Gaston Horner, M.D.

• Surgery Physician in Olney, TX
• Providers in Olney, TX by specialty
• Surgery Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2008; 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.