NPIMap

Individual provider Active NPI

Imran Fayaz, M.D.

  • Neurological Surgery Physician
  • Conroe, TX
National Provider Identifier
1396717351
Registry record updated Jun 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
M1090 Issued in TX
Practice address
500 Medical Center Blvd Ste 222
Conroe, TX 77304-2800
Phone
(281) 880-0700
Fax
(281) 419-9997
NPI assigned
Feb 3, 2006
Last updated
Jun 15, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X M1090 TX Primary

Addresses

Primary practice location

500 Medical Center Blvd Ste 222
Conroe, TX 77304-2800

Mailing address

PO Box 131479
The Woodlands, TX 77393-1479
Phone (281) 779-4030

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050801000476 TX Practitioner - Neurosurgery 9537197520 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

500 Medical Ctr Blvd
Suite 222
Conroe, TX 77304-2800
Phone (281) 779-4030

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion47
Laminectomy or laminotomy (partial removal of spine bones)16

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Imran Fayaz, M.D., P.a. Neurological Surgery CurrentSince Aug 2, 2009 Accepting new patients
Citizens Medical Center County of Victoria Past Accepting new patients

Locations

500 Medical Center Blvd
Ste 222
Conroe, TX 77304
Phone (936) 441-8635

504 Medical Center Blvd
Conroe, TX 77304
Phone (936) 539-1111

22999 Highway 59 N
Ste 290
Kingwood, TX 77339
Phone (281) 348-3321

1111 Medical Plaza Dr
Ste 200
The Woodlands, TX 77380
Phone (281) 880-0700

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JGBHAA/Endpoint/JGBHAA

Organizations & group practices 2

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.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1138924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686787200000",
    "number": "1396717351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 131479",
            "city": "THE WOODLANDS",
            "state": "TX",
            "postal_code": "773931479",
            "telephone_number": "281-779-4030",
            "fax_number": "281-419-9997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 MEDICAL CENTER BLVD STE 222",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773042800",
            "telephone_number": "281-880-0700",
            "fax_number": "281-419-9997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAYAZ",
        "first_name": "IMRAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-03",
        "last_updated": "2023-06-15",
        "certification_date": "2023-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "TX",
            "license": "M1090",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conroe, TX

Sources for this page

Verify at the official NPI Registry.