Provider Demographics
NPI:1558051987
Name:ALEX SHOKOUHI MOHSENI MD PC
Entity Type:Organization
Organization Name:ALEX SHOKOUHI MOHSENI MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:
Authorized Official - Last Name:MOHSENI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:469-209-1802
Mailing Address - Street 1:8951 CYPRESS WATERS BLVD STE 160-1045
Mailing Address - Street 2:
Mailing Address - City:COPPELL
Mailing Address - State:TX
Mailing Address - Zip Code:75019-4661
Mailing Address - Country:US
Mailing Address - Phone:469-209-1802
Mailing Address - Fax:
Practice Address - Street 1:1764 HAMLET ST
Practice Address - Street 2:
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94403-1111
Practice Address - Country:US
Practice Address - Phone:469-209-1802
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ALEX SHOKOUHI MOHSENI MD PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-05-09
Last Update Date:2023-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty