Provider Demographics
NPI:1780635599
Name:ALHEZAYEN, MOHAMMED A (MD)
Entity Type:Individual
Prefix:
First Name:MOHAMMED
Middle Name:A
Last Name:ALHEZAYEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 PRESTON RD
Mailing Address - Street 2:SUITE 267 PMB 215
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-5175
Mailing Address - Country:US
Mailing Address - Phone:214-244-1468
Mailing Address - Fax:972-517-7888
Practice Address - Street 1:6101 CHAPEL HILL BLVD
Practice Address - Street 2:SUITE 201
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-8446
Practice Address - Country:US
Practice Address - Phone:972-403-0583
Practice Address - Fax:972-608-8736
Is Sole Proprietor?:No
Enumeration Date:2006-05-15
Last Update Date:2015-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN8879207R00000X, 208M00000X
AZ33614208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ139624Medicare PIN
AZZ145951Medicare PIN