Healthcare Provider Details

I. General information

NPI: 1417181678
Provider Name (Legal Business Name): FAREED AHMED KHOUQEER M.D.,FACS, MBA.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/03/2009
Last Update Date: 05/03/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 ALZAHRAWI KFSHRC 16
RIYADH CENTRAL
11211
SA

IV. Provider business mailing address

7901 CAMBRIDGE ST 28
HOUSTON TX
77054-3050
US

V. Phone/Fax

Practice location:
  • Phone: 966-464-7272
  • Fax:
Mailing address:
  • Phone: 713-791-9751
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License NumberH1719
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License NumberDR-29306
License Number StateCO
# 3
Primary TaxonomyN
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License NumberMD038224E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: