1881381069 NPI number — ABDUS SAMAD SYED MOHAMMED MBBS

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1881381069 NPI number — ABDUS SAMAD SYED MOHAMMED MBBS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SYED MOHAMMED
Provider First Name:
ABDUS SAMAD
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MBBS
Provider Gender Code:
M

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:
1881381069
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/17/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
INTERNAL MEDICINE RESIDENCY, BAPTIST HOSPITALS OF SOUTH
Provider Second Line Business Mailing Address:
EAST TEXAS 3282 COLLEGE STREET
Provider Business Mailing Address City Name:
BEAUMONT
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77701
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
409-212-7463
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
BAPTIST HOSPITALS OF SOUTHEAST TEXAS
Provider Second Line Business Practice Location Address:
3080 COLLEGE ST
Provider Business Practice Location Address City Name:
BEAUMONT
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77701
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
409-212-5000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/19/2023

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 390200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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