Provider Demographics
NPI:1578287280
Name:MOHAMED, ADE
Entity Type:Individual
Prefix:
First Name:ADE
Middle Name:
Last Name:MOHAMED
Suffix:
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 1:7826 NEW WORLD APT 2
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78239-3513
Mailing Address - Country:US
Mailing Address - Phone:210-848-7062
Mailing Address - Fax:
Practice Address - Street 1:7826 NEW WORLD DR
Practice Address - Street 2:APT 2
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78239-7823
Practice Address - Country:US
Practice Address - Phone:210-848-7062
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-27
Last Update Date:2022-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347E00000XTransportation ServicesTransportation Broker