Provider Demographics
NPI:1891790911
Name:AL-FAHL, MOHAMMED-TAREK (MD)
Entity Type:Individual
Prefix:DR
First Name:MOHAMMED-TAREK
Middle Name:
Last Name:AL-FAHL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:M
Other - Middle Name:TAREK
Other - Last Name:AL-FAHL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:13603 MICHEL RD
Mailing Address - Street 2:
Mailing Address - City:TOMBALL
Mailing Address - State:TX
Mailing Address - Zip Code:77375-6410
Mailing Address - Country:US
Mailing Address - Phone:281-351-7261
Mailing Address - Fax:281-351-2515
Practice Address - Street 1:13603 MICHEL RD
Practice Address - Street 2:
Practice Address - City:TOMBALL
Practice Address - State:TX
Practice Address - Zip Code:77375-6410
Practice Address - Country:US
Practice Address - Phone:281-351-7261
Practice Address - Fax:281-351-2515
Is Sole Proprietor?:No
Enumeration Date:2005-06-15
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL2085207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX153467901Medicaid
TXH61676Medicare UPIN
TX153467901Medicaid