Provider Demographics
NPI:1760533004
Name:MEHDI MUHAMMAD MD P.A
Entity Type:Organization
Organization Name:MEHDI MUHAMMAD MD P.A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MEHDI
Authorized Official - Middle Name:
Authorized Official - Last Name:MUHAMMAD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-240-2711
Mailing Address - Street 1:1415 HIGHWAY 6
Mailing Address - Street 2:BLDG D400
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-5112
Mailing Address - Country:US
Mailing Address - Phone:281-240-2711
Mailing Address - Fax:281-240-2770
Practice Address - Street 1:1415 HIGHWAY 6
Practice Address - Street 2:BLDG D400
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-5112
Practice Address - Country:US
Practice Address - Phone:281-240-2711
Practice Address - Fax:281-240-2770
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-15
Last Update Date:2014-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00217ZMedicare ID - Type Unspecified
TXG34043Medicare UPIN