Organization Active NPI

Fairmont Family Practice

  • Family Medicine Physician
  • La Porte, TX
National Provider Identifier
1467276774
Registry record updated Nov 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
FAIRMONT FAMILY PRACTICE
Practice address
400 W Fairmont Pkwy Ste B
La Porte, TX 77571-6308
Phone
(346) 222-7370
Fax
(281) 487-7054
NPI assigned
Nov 13, 2024
Last updated
Nov 13, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2024

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

Authorized official

Name
Dr. Ashu Syal, MDNPI 1124064779
Title
Owner & Physician
Phone
(346) 222-7370

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

400 W Fairmont Pkwy Ste B
La Porte, TX 77571-6308

Mailing address

400 W Fairmont Pkwy Ste B
La Porte, TX 77571-6308
Phone (346) 222-7370

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250709002125 TX Part B Supplier - Clinic/Group Practice 0840704078 Receives reassigned benefits from 2 practitioners
Practice locations: La Porte, TX

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2318275Fairmont Family Practice400 W Fairmont Pkwy Ste B, La Porte, TX 77571Certificate of waiverFeb 6, 2027

National Provider Directory

National Provider Directory

Locations

400 W Fairmont Pkwy
Ste B
La Porte, TX 77571
Phone (346) 222-7370

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1731456000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731456000000",
    "number": "1467276774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 W FAIRMONT PKWY STE B",
            "city": "LA PORTE",
            "state": "TX",
            "postal_code": "775716308",
            "telephone_number": "346-222-7370",
            "fax_number": "281-487-7054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 W FAIRMONT PKWY STE B",
            "city": "LA PORTE",
            "state": "TX",
            "postal_code": "775716308",
            "telephone_number": "346-222-7370",
            "fax_number": "281-487-7054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAIRMONT FAMILY PRACTICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-13",
        "last_updated": "2024-11-13",
        "certification_date": "2024-11-13",
        "status": "A",
        "authorized_official_last_name": "SYAL",
        "authorized_official_first_name": "ASHU",
        "authorized_official_title_or_position": "OWNER & PHYSICIAN",
        "authorized_official_telephone_number": "346-222-7370",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Porte, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.