Active NPI
Bassam M Fakhouri, M.D.
- Pediatrics Physician
- Tucson, AZ
National Provider Identifier
1841366267
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 27732
- Practice address
- 4175 S Alamo Ave
Davis-Monthan AFB
Tucson, AZ 85707-6097 - Phone
- (520) 228-2600
- NPI assigned
- Nov 28, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 27732 | AZ | Primary |
Addresses
Primary practice location
4175 S Alamo Ave
Davis-Monthan AFB
Tucson, AZ 85707-6097
Mailing address
8327 W Pontiac Dr
Peoria, AZ 85382-1414
Phone (623) 825-2769
Other names 1
- Bassam Fakhouri
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 27732 | AZ | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164672000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1841366267",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8327 W PONTIAC DR",
"city": "PEORIA",
"state": "AZ",
"postal_code": "853821414",
"telephone_number": "623-825-2769"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4175 S ALAMO AVE",
"address_2": "DAVIS-MONTHAN AFB",
"city": "TUCSON",
"state": "AZ",
"postal_code": "857076097",
"telephone_number": "520-228-2600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FAKHOURI",
"first_name": "BASSAM",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-28",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "AZ",
"license": "27732",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "BASSAM",
"last_name": "FAKHOURI",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Tucson, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.