Provider Demographics
NPI:1669535357
Name:ALAM, MOHAMMAD MONJURUL (MD)
Entity type:Individual
Prefix:DR
First Name:MOHAMMAD
Middle Name:MONJURUL
Last Name:ALAM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:MD
Other - Middle Name:MONJURUL
Other - Last Name:ALAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:17415 FOUNTAINVIEW CIR
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-3099
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1411 KENTSHIRE AVE
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479
Practice Address - Country:US
Practice Address - Phone:832-772-9345
Practice Address - Fax:844-350-6551
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2018-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP0332207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine