Provider Demographics
NPI:1255624516
Name:NABI, MAHAMUDUN (MD)
Entity type:Individual
Prefix:
First Name:MAHAMUDUN
Middle Name:
Last Name:NABI
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 1:701 W 5TH ST
Mailing Address - Street 2:
Mailing Address - City:ODESSA
Mailing Address - State:TX
Mailing Address - Zip Code:79763-4206
Mailing Address - Country:US
Mailing Address - Phone:432-703-5004
Mailing Address - Fax:432-335-1807
Practice Address - Street 1:2301 W MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79701-5829
Practice Address - Country:US
Practice Address - Phone:432-620-1160
Practice Address - Fax:432-620-1156
Is Sole Proprietor?:No
Enumeration Date:2011-05-19
Last Update Date:2025-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXT80012084P0800X
CT620972084P0800X
NY390200000X
CA2004852084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program