Provider Demographics
NPI:1922212620
Name:MAQBOOL, MOHSIN (MD)
Entity Type:Individual
Prefix:
First Name:MOHSIN
Middle Name:
Last Name:MAQBOOL
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 1:4032 MCDERMOTT RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-7733
Mailing Address - Country:US
Mailing Address - Phone:972-769-9000
Mailing Address - Fax:972-769-0035
Practice Address - Street 1:4032 MCDERMOTT RD
Practice Address - Street 2:STE 100
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-7733
Practice Address - Country:US
Practice Address - Phone:972-769-9000
Practice Address - Fax:972-769-0035
Is Sole Proprietor?:No
Enumeration Date:2007-05-10
Last Update Date:2016-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301087784208000000X, 2084N0402X, 2084S0012X
TXP92212084N0402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child Neurology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2084S0012XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySleep Medicine