Provider Demographics
NPI:1700047032
Name:ALEEM, MOHAMMED ABDUL (DO)
Entity Type:Individual
Prefix:
First Name:MOHAMMED
Middle Name:ABDUL
Last Name:ALEEM
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1900 ENCHANTED WAY STE 100
Mailing Address - Street 2:
Mailing Address - City:GRAPEVINE
Mailing Address - State:TX
Mailing Address - Zip Code:76051-0965
Mailing Address - Country:US
Mailing Address - Phone:972-867-3627
Mailing Address - Fax:
Practice Address - Street 1:5201 HARRY HINES BLVD
Practice Address - Street 2:HOUSE STAFF & GME
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75235-7708
Practice Address - Country:US
Practice Address - Phone:214-590-8058
Practice Address - Fax:817-421-7560
Is Sole Proprietor?:No
Enumeration Date:2008-06-19
Last Update Date:2014-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP0531207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology