1073089124 NPI number — MOHAMMED U SHAIKH MD PA

Table of content: (NPI 1073089124)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1073089124 NPI number — MOHAMMED U SHAIKH MD PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MOHAMMED U SHAIKH MD PA
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1073089124
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/25/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8650 JOHN HICKMAN PKWY
Provider Second Line Business Mailing Address:
STE 601
Provider Business Mailing Address City Name:
FRISCO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75034
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
12606 GREENVILLE AVE STE 245
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DALLAS
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75243-1921
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
972-435-4002
Provider Business Practice Location Address Fax Number:
972-435-4105
Provider Enumeration Date:
10/16/2018

Additional Information

Authorized Official

Authorized Official Last Name:
SHAIKH
Authorized Official First Name:
MOHAMMED
Authorized Official Middle Name:
USMAN
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
419-297-6300

Provider Taxonomy Codes

  • Taxonomy code: 207LP2900X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1952696635 . This is a "NPI" identifier . This identifiers is of the category "OTHER".




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