Provider Demographics
NPI:1740260900
Name:AL-SABBAGH, MOUHAMAD RADWAN (MD)
Entity type:Individual
Prefix:
First Name:MOUHAMAD
Middle Name:RADWAN
Last Name:AL-SABBAGH
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:PO BOX 540088
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77254-0088
Mailing Address - Country:US
Mailing Address - Phone:713-850-1190
Mailing Address - Fax:713-850-1327
Practice Address - Street 1:1140 BUSINESS CENTER DR STE 380
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77043-2742
Practice Address - Country:US
Practice Address - Phone:713-467-1750
Practice Address - Fax:713-467-1410
Is Sole Proprietor?:No
Enumeration Date:2006-01-21
Last Update Date:2023-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ0421207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
8758B0Medicare PIN
E49844Medicare UPIN