Individual provider Active NPI

Abdulla Fakhro, MD

  • Plastic and Reconstructive Surgery Physician
  • Houston, TX
National Provider Identifier
1952564023
Registry record updated Dec 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X
License
R3506 Issued in TX
Practice address
12121 Richmond Ave
Suite 101
Houston, TX 77082-2432
Phone
(281) 741-5910
NPI assigned
Jul 8, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X MT193364 PA
Student in an Organized Health Care Education/Training Program 390200000X MT193364 PA
Plastic and Reconstructive Surgery Physician 2086S0122X R3506 TX Primary

Addresses

Primary practice location

12121 Richmond Ave
Suite 101
Houston, TX 77082-2432

Mailing address

12121 Richmond Ave
Suite 101
Houston, TX 77082-2432
Phone (281) 741-5910

Other practice location 1

5600 Kirby Dr
Suite M
Houston, TX 77005-2449
Phone (713) 360-6857

Other practice location 2

500 Medical Center Blvd
Suite 335
Conroe, TX 77304-2889
Phone (713) 360-6857

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

LicenseStateTypeSpecialty
R3506TXMDPlastic and Reconstructive Surgery Physician
MT193364PAMDStudent in an Organized Health Care Education/Training Program

Interoperability endpoints

  • Direct secure messaging: afakhro168838@directhoustonmethodist.org

NPI Registry JSON

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

{
    "created_epoch": "1215475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576540800000",
    "number": "1952564023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12121 RICHMOND AVE",
            "address_2": "SUITE 101",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770822432",
            "telephone_number": "281-741-5910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12121 RICHMOND AVE",
            "address_2": "SUITE 101",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770822432",
            "telephone_number": "281-741-5910"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5600 Kirby Dr",
            "address_2": "Suite M",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770052449",
            "country_code": "US",
            "telephone_number": "713-360-6857",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "500 Medical Center Blvd",
            "address_2": "Suite 335",
            "address_purpose": "LOCATION",
            "city": "Conroe",
            "state": "TX",
            "postal_code": "773042889",
            "country_code": "US",
            "telephone_number": "713-360-6857",
            "fax_number": "713-583-1113",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FAKHRO",
        "first_name": "ABDULLA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-08",
        "last_updated": "2019-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "PA",
            "license": "MT193364",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "PA",
            "license": "MT193364",
            "primary": false
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "TX",
            "license": "R3506",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.