Provider Demographics
NPI:1013001346
Name:MOHAMED, SAMIRA T (MD,MPH)
Entity Type:Individual
Prefix:
First Name:SAMIRA
Middle Name:T
Last Name:MOHAMED
Suffix:
Gender:F
Credentials:MD,MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5700 N EXPRESSWAY # 77
Mailing Address - Street 2:SUITE 102
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78526-4353
Mailing Address - Country:US
Mailing Address - Phone:956-350-6561
Mailing Address - Fax:956-350-6700
Practice Address - Street 1:5700 N EXPRESSWAY # 77
Practice Address - Street 2:SUITE 102
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78526-4353
Practice Address - Country:US
Practice Address - Phone:956-350-6561
Practice Address - Fax:956-350-6700
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2012-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM5385207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX201049801Medicaid
TXTXB145975Medicare PIN