Healthcare Provider Details

I. General information

NPI: 1114830577
Provider Name (Legal Business Name): UNKNOWN IRUM FATIMA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: IRUM FATIMA MBBS, MD

II. Dates (important events)

Enumeration Date: 09/25/2026
Last Update Date: 09/25/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1514 JEFFERSON HWY APT 3
NEW ORLEANS LA
70121-2451
US

IV. Provider business mailing address

1168 LAKE AVE APT 110
METAIRIE LA
70005-2415
US

V. Phone/Fax

Practice location:
  • Phone: 713-791-4231
  • Fax:
Mailing address:
  • Phone: 713-791-4231
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number354625
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: