MEDICARE: FAHAD OMAR MD PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RC0200X	Critical Care Medicine (Internal Medicine) Physician
2	207RS0012X	Sleep Medicine (Internal Medicine) Physician	R0293	TX
3	207RA0201X	Allergy & Immunology (Internal Medicine) Physician
4	207RP1001X	Pulmonary Disease Physician	R0293	TX

General Provider Information

NPI Number	:	1326580804
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAHAD OMAR MD PA

Provider Business Mailing Address
First Line	:	1512 N ZARAGOZA RD STE B
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79936-8903
Country	:	US
Telephone Number	:	915-213-0900
Fax Number	:	915-271-4145

Provider Business Practice Location Address
First Line	:	5539 N MESA ST
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79912-5422
Country	:	US
Telephone Number	:	915-213-0900
Fax Number	:	915-271-4145

Authorized Official
Title or Position	:	OWNER/ PHYSICIAN
Name	:	FAHAD OMAR
Credential	:	M.D.
Telephone Number	:	915-213-0900

Provider Enumeration Date	:	11/15/2016
Last Update Date	:	04/18/2025

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