MEDICARE: WIFUMAM PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208600000X	Surgery Physician	N0535	TX

General Provider Information

NPI Number	:	1255587879
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WIFUMAM PA

Provider Business Mailing Address
First Line	:	PO BOX 690786
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77269-0786
Country	:	US
Telephone Number	:	281-653-6544
Fax Number	:

Provider Business Practice Location Address
First Line	:	5220 FM 2920 RD STE 120
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77388-3003
Country	:	US
Telephone Number	:	281-653-6544
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	IRFAN I WADIWALA
Credential	:
Telephone Number	:	281-653-6544

Provider Enumeration Date	:	08/14/2008
Last Update Date	:	11/07/2025

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Directions to “WIFUMAM PA ” Practice Location

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