Individual provider Active NPI

Faheem Shujauddin, M.D.

  • Specialist
  • Houston, TX
National Provider Identifier
1356447619
Registry record updated Sep 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
H7508 Issued in TX
Practice address
12121 Richmond Ave
Suite # 204
Houston, TX 77082-2432
Phone
(281) 531-8013
Fax
(281) 531-7237
NPI assigned
Sep 15, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 26, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X H7508 TX Primary

Addresses

Primary practice location

12121 Richmond Ave
Suite # 204
Houston, TX 77082-2432

Mailing address

12121 Richmond Ave
Suite # 204
Houston, TX 77082-2432
Phone (281) 531-8013

Other identifiers 2

IdentifierTypeStateIssuer
122856105MedicaidTX
E38571OtherTXUPIN #

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120911000122 TX Practitioner - Internal Medicine 6800898214

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
H7508TXMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316995200000",
    "number": "1356447619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12121 RICHMOND AVE",
            "address_2": "SUITE # 204",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770822432",
            "telephone_number": "281-531-8013",
            "fax_number": "281-531-7237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12121 RICHMOND AVE",
            "address_2": "SUITE # 204",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770822432",
            "telephone_number": "281-531-8013",
            "fax_number": "281-531-7237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUJAUDDIN",
        "first_name": "FAHEEM",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-15",
        "last_updated": "2011-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "TX",
            "license": "H7508",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "122856105",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UPIN #",
            "identifier": "E38571",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.