Provider Demographics
NPI:1659897908
Name:AWAD, MOHANNAD
Entity type:Individual
Prefix:
First Name:MOHANNAD
Middle Name:
Last Name:AWAD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3989
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78502-3989
Mailing Address - Country:US
Mailing Address - Phone:956-362-8767
Mailing Address - Fax:956-362-2548
Practice Address - Street 1:2603 MICHAELANGELO DR
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-1417
Practice Address - Country:US
Practice Address - Phone:956-362-8767
Practice Address - Fax:956-362-2548
Is Sole Proprietor?:No
Enumeration Date:2017-08-18
Last Update Date:2024-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXT4311208800000X, 208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology