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General NPI Number Information
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NPI Number | 1255587879
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Entity Type | Organization
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Legal Business Name | WIFUMAM PA
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Dates
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Enumeration Date | 08/14/2008
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Last Update Date | 11/07/2025
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Provider Practice Location Address
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Address Line | 5220 FM 2920 RD STE 120
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City | SPRING
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State | TX
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Zip | 77388-3003
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Country | US
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Telephone | 281-653-6544
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 690786
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City | HOUSTON
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State | TX
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Zip | 77269-0786
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Country | US
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Telephone | 281-653-6544
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | IRFAN I WADIWALA
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Credential |
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Telephone | 281-653-6544
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | N0535
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License Number State | TX
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