Provider Demographics
NPI:1285859389
Name:KABIR, MOHAMMAD HUMAYUN (MD)
Entity Type:Individual
Prefix:DR
First Name:MOHAMMAD
Middle Name:HUMAYUN
Last Name:KABIR
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 1:1000 W CANNON ST
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76104-3029
Mailing Address - Country:US
Mailing Address - Phone:817-725-7900
Mailing Address - Fax:682-207-1030
Practice Address - Street 1:9947 N MACARTHUR BLVD
Practice Address - Street 2:STE 150
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75063-4716
Practice Address - Country:US
Practice Address - Phone:817-877-5858
Practice Address - Fax:817-335-4418
Is Sole Proprietor?:No
Enumeration Date:2007-04-16
Last Update Date:2022-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ6037207R00000X, 207RN0300X
ALMD.29441207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSBK7437507OtherDEA