Healthcare Provider Details

I. General information

NPI: 1366979908
Provider Name (Legal Business Name): FAIZA CHOUDHRY DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/14/2017
Last Update Date: 12/12/2023
Certification Date: 12/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3828 S 1ST ST
AUSTIN TX
78704-7048
US

IV. Provider business mailing address

6210 E HWY 290
AUSTIN TX
78723-1142
US

V. Phone/Fax

Practice location:
  • Phone: 512-443-1311
  • Fax: 512-406-6266
Mailing address:
  • Phone: 512-344-0450
  • Fax: 512-406-7318

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberU3495
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: