Provider Demographics
NPI:1942522420
Name:MOHAMMAD I. MUGHAL, M.D.
Entity Type:Organization
Organization Name:MOHAMMAD I. MUGHAL, M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CLARE
Authorized Official - Middle Name:R
Authorized Official - Last Name:BURGDORF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-926-4641
Mailing Address - Street 1:951 W MAGNOLIA AVE
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76104-4524
Mailing Address - Country:US
Mailing Address - Phone:817-926-4641
Mailing Address - Fax:817-921-0208
Practice Address - Street 1:951 W MAGNOLIA AVE
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76104-4524
Practice Address - Country:US
Practice Address - Phone:817-926-4641
Practice Address - Fax:817-921-0208
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-24
Last Update Date:2010-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE8747207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty