Provider Demographics
NPI:1568154771
Name:ABDELGHANY, KAREEM MOHAMED IV
Entity Type:Individual
Prefix:
First Name:KAREEM
Middle Name:MOHAMED
Last Name:ABDELGHANY
Suffix:IV
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 W PARK BLVD APT 202
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75075-2662
Mailing Address - Country:US
Mailing Address - Phone:469-961-9938
Mailing Address - Fax:
Practice Address - Street 1:1001 W PARK BLVD APT 202
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75075-2662
Practice Address - Country:US
Practice Address - Phone:469-961-9938
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-25
Last Update Date:2023-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX247662156FC0801X, 156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician
No156FC0801XEye and Vision Services ProvidersTechnician/TechnologistContact Lens FitterGroup - Single Specialty