Provider Demographics
NPI:1912982885
Name:ZEINEDDIN, MOHAMAD A (MD)
Entity Type:Individual
Prefix:
First Name:MOHAMAD
Middle Name:A
Last Name:ZEINEDDIN
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 1:1400 N IH 35
Mailing Address - Street 2:SUITE 300
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78701-1926
Mailing Address - Country:US
Mailing Address - Phone:512-324-8300
Mailing Address - Fax:512-324-8301
Practice Address - Street 1:7900 FM 1826
Practice Address - Street 2:SUITE 170
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78737-1407
Practice Address - Country:US
Practice Address - Phone:512-324-9250
Practice Address - Fax:512-324-9251
Is Sole Proprietor?:No
Enumeration Date:2005-12-13
Last Update Date:2014-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH5103207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX131633314Medicaid
TX131633311Medicaid
TX131633310Medicaid
TX8CU901OtherBCBS
TXP01037423OtherRAILROAD MEDICARE
TX131633313Medicaid
TX8ET557OtherBCBS
TX340263YL9XMedicare PIN
TX131633311Medicaid
TXTXB130152Medicare PIN
TX8ET557OtherBCBS
TX131633313Medicaid