Healthcare Provider Details

I. General information

NPI: 1659330504
Provider Name (Legal Business Name): FAISEL M ZAMAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/20/2006
Last Update Date: 06/29/2023
Certification Date: 06/29/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 SUMMER LEE DR
ROCKWALL TX
75032-5452
US

IV. Provider business mailing address

PO BOX 5409
ABILENE TX
79608-5409
US

V. Phone/Fax

Practice location:
  • Phone: 972-771-8111
  • Fax:
Mailing address:
  • Phone: 325-437-8655
  • Fax: 325-437-8647

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number54-12703-1205
License Number StateUT
# 2
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License NumberP5016
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: