Healthcare Provider Details

I. General information

NPI: 1457671034
Provider Name (Legal Business Name): FUAD YAHIA MAUFA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/07/2010
Last Update Date: 06/18/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

SAUDI ARAMCO MEDICAL SERVICE ORGANIZATION
DHARAN EASTERN
31311
SA

IV. Provider business mailing address

9009 WEST LOOP S MS 1095
HOUSTON TX
77096-1719
US

V. Phone/Fax

Practice location:
  • Phone: 01196638778930
  • Fax:
Mailing address:
  • Phone: 713-432-4071
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: