Individual provider Active NPI

Mourad S Fawzy, DDS

  • Dentist
  • Lakeway, TX
National Provider Identifier
1679162523
Registry record updated Sep 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
37422 Issued in TX
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, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 7, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

TypeEndpointUseAffiliation
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220511002419 CA Order and Referring Only - DentistPractitioner - Dentist 8820475973

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
37422TXMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Titanium Dental Group PLLC General Practice CurrentSince Aug 25, 2025 Accepting new patients
Lakeway Dental Solutions. LLC Dentist CurrentSince Aug 25, 2025 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.

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

Verify at the official NPI Registry.