Provider Demographics
NPI:1164678280
Name:AL-SAADI, MUKHTAR A (MD)
Entity Type:Individual
Prefix:
First Name:MUKHTAR
Middle Name:A
Last Name:AL-SAADI
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 1:6565 FANNIN ST
Mailing Address - Street 2:SUITE 1003
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2703
Mailing Address - Country:US
Mailing Address - Phone:713-441-1100
Mailing Address - Fax:713-790-2643
Practice Address - Street 1:6565 FANNIN ST
Practice Address - Street 2:SUITE 1003
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2703
Practice Address - Country:US
Practice Address - Phone:713-441-1100
Practice Address - Fax:713-790-2643
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-08
Last Update Date:2017-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301091721207R00000X
TXN9672207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8FZ544OtherBCBS
TXP01773501OtherRR MEDICARE
TX359489702Medicaid
TX510888ZSWDMedicare PIN