| Fairway Medical Clinic | |
|
4910 Telephone Rd Houston TX 77087-3504 | |
| (713) 641-3900 | |
| (713) 641-3901 |
| Full Name | Fairway Medical Clinic |
|---|---|
| Speciality | Internal Medicine |
| Location | 4910 Telephone Rd, Houston, Texas |
| Authorized Official Name and Position | Murtaza Mussaji (PRESIDENT) |
| Authorized Official Contact | 7136413900 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Fairway Medical Clinic 4910 Telephone Rd Houston TX 77087-3504 Ph: (713) 641-3900 | Fairway Medical Clinic 4910 Telephone Rd Houston TX 77087-3504 Ph: (713) 641-3900 |
| NPI Number | 1164679494 |
|---|---|
| Provider Enumeration Date | 08/18/2008 |
| Last Update Date | 08/25/2011 |
| Medicare PECOS PAC ID | 9133276264 |
|---|---|
| Medicare Enrollment ID | O20090407000434 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164679494 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | M3335 (Texas) | Secondary |
| 207R00000X | Internal Medicine | M3335 (Texas) | Primary |
| Provider Name | Murtaza Mussaji |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1487705034 PECOS PAC ID: 3173612033 Enrollment ID: I20071130000360 |
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