Provider Demographics
NPI:1164642666
Name:KAMILI, FAYAK S (MD)
Entity type:Individual
Prefix:DR
First Name:FAYAK
Middle Name:S
Last Name:KAMILI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 2365
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-0044
Mailing Address - Country:US
Mailing Address - Phone:972-379-7129
Mailing Address - Fax:214-291-5829
Practice Address - Street 1:5150 WARREN PKWY
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-7462
Practice Address - Country:US
Practice Address - Phone:972-379-7129
Practice Address - Fax:214-291-5829
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-26
Last Update Date:2024-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN4507207RI0011X
NE4576207RC0000X
ND20677207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Single Specialty
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease