MEDICARE: DR. SAMER FAHOUM MD FCCP

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	Q6187	TX
2	207RP1001X	Pulmonary Disease Physician	Q6187	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	Q6187	OTHER	TX	MEDICAL LICENSE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1548375827
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SAMER FAHOUM MD FCCP

Provider Business Mailing Address
First Line	:	1201 FAIRMOUNT AVE
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76104-4215
Country	:	US
Telephone Number	:	817-335-5288
Fax Number	:	817-338-0927

Provider Business Practice Location Address
First Line	:	515 W MAYFIELD RD STE 240
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76014-2084
Country	:	US
Telephone Number	:	817-476-2882
Fax Number	:	817-394-6202

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/20/2006
Last Update Date	:	07/30/2025

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Directions to “ DR. SAMER FAHOUM MD FCCP” Practice Location

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