Provider Demographics
NPI:1144426198
Name:UDDIN, MUHAMMAD M (MD)
Entity Type:Individual
Prefix:
First Name:MUHAMMAD
Middle Name:M
Last Name:UDDIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4351 DFW TPKE
Mailing Address - Street 2:STE 150
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75211-1501
Mailing Address - Country:US
Mailing Address - Phone:469-488-4300
Mailing Address - Fax:
Practice Address - Street 1:4351 DFW TPKE
Practice Address - Street 2:STE 150
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75211-1501
Practice Address - Country:US
Practice Address - Phone:469-488-4300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-26
Last Update Date:2013-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK25451207QA0000X
TXN2855208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No207QA0000XAllopathic & Osteopathic PhysiciansFamily MedicineAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX213476902Medicaid
OK200119050 AMedicaid
TX213476904Medicaid
TX213476903Medicaid
NM47134356Medicaid
TX213476901Medicaid
TX213476901Medicaid
TX213476902Medicaid