Provider Demographics
NPI:1396934113
Name:SAAD, MOHAMAD D (DO)
Entity type:Individual
Prefix:
First Name:MOHAMAD
Middle Name:D
Last Name:SAAD
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:909 9TH AVE
Mailing Address - Street 2:STE 205
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76104-3916
Mailing Address - Country:US
Mailing Address - Phone:817-332-0788
Mailing Address - Fax:817-332-0787
Practice Address - Street 1:909 9TH AVE STE 205
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76104-3916
Practice Address - Country:US
Practice Address - Phone:817-332-0786
Practice Address - Fax:817-332-0787
Is Sole Proprietor?:No
Enumeration Date:2007-10-17
Last Update Date:2019-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101015953208600000X
TXN2765208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8AC339OtherBLUE CROSS BLUE SHIELD
TX8L14806Medicare PIN