Active NPI
Mourad S Fawzy, DDS
- Dentist
- Lakeway, TX
National Provider Identifier
1679162523
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 37422
- Practice address
- 1310 Ranch Road 620 S Ste B6
Lakeway, TX 78734-6346 - Phone
- (512) 263-0064
- NPI assigned
- Jan 14, 2021
- Last updated
- Sep 7, 2025
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 37422 | TX | Primary |
| Dentist | 122300000X | 105947 | CA |
Addresses
Primary practice location
1310 Ranch Road 620 S Ste B6
Lakeway, TX 78734-6346
Mailing address
1310 Ranch Road 620 S Ste B6
Lakeway, TX 78734-6346
Phone (512) 263-0064
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | drfawzy@lakewaydentalassociates.com | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220511002419 | CA | Order and Referring Only - Dentist | 8820475973 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 37422 | TX | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Titanium Dental Group PLLC | General Practice | Current | Accepting new patients |
| Lakeway Dental Solutions. LLC | Dentist | Current | Accepting new patients |
Locations
1310 Ranch Road 620 S
Ste B6
Lakeway, TX 78734
Phone (512) 263-0064
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.
-
dba Lakeway Dental Associates
- General Practice Dentistry
- Lakeway, TX
- NPI 1164305520
-
- Dentist
- Lakeway, TX
- NPI 1538749270
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1610582400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757203200000",
"number": "1679162523",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1310 RANCH ROAD 620 S STE B6",
"city": "LAKEWAY",
"state": "TX",
"postal_code": "787346346",
"telephone_number": "512-263-0064"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1310 RANCH ROAD 620 S STE B6",
"city": "LAKEWAY",
"state": "TX",
"postal_code": "787346346",
"telephone_number": "512-263-0064"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FAWZY",
"first_name": "MOURAD",
"middle_name": "S",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-01-14",
"last_updated": "2025-09-07",
"certification_date": "2025-09-07",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TX",
"license": "37422",
"primary": true
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "105947",
"primary": false
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "drfawzy@lakewaydentalassociates.com",
"affiliation": "N",
"endpointDescription": "email",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "1310 Ranch Road 620 S Ste B6",
"city": "Lakeway",
"state": "TX",
"country_code": "US",
"postal_code": "787346346",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Lakeway, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.