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General NPI Number Information
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NPI Number | 1033425087
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Entity Type | Individual
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Provider Name | FAHAD JAVED M.D.,
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Gender | Male
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Dates
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Enumeration Date | 08/27/2010
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Last Update Date | 06/03/2024
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Provider Practice Location Address
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Address Line | 601 RIVER POINTE DR STE 105
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City | CONROE
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State | TX
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Zip | 77304-2943
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Country | US
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Telephone | 936-539-5577
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Fax | 936-539-5550
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Provider Business Mailing Address
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Address Line | 4215 15TH ST
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City | GULFPORT
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State | MS
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Zip | 39501-2523
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Country | US
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Telephone | 228-863-5211
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Fax | 228-863-4101
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 266935
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number | 26033
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License Number State | MS
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Taxonomy #3
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number | DR.0062918
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License Number State | CO
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Taxonomy #4
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number | S0909
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License Number State | TX
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Taxonomy #5
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number | MD.206853
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License Number State | LA
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