Provider Demographics
NPI:1881266955
Name:MOHAMMED, AFSHAN (RD)
Entity type:Individual
Prefix:
First Name:AFSHAN
Middle Name:
Last Name:MOHAMMED
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:409 BOUNDRY ST UNIT 101
Mailing Address - Street 2:
Mailing Address - City:MINEOLA
Mailing Address - State:TX
Mailing Address - Zip Code:75773-2305
Mailing Address - Country:US
Mailing Address - Phone:318-572-6157
Mailing Address - Fax:800-708-7349
Practice Address - Street 1:409 BOUNDRY ST UNIT 101
Practice Address - Street 2:
Practice Address - City:MINEOLA
Practice Address - State:TX
Practice Address - Zip Code:75773-2305
Practice Address - Country:US
Practice Address - Phone:318-572-6157
Practice Address - Fax:800-708-7349
Is Sole Proprietor?:No
Enumeration Date:2021-07-16
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX86004029OtherCDR
TXDT83048OtherRDL