1912982885 NPI number — MOHAMAD A. ZEINEDDIN M.D.

Table of content: MOHAMAD A. ZEINEDDIN M.D. (NPI 1912982885)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1912982885 NPI number — MOHAMAD A. ZEINEDDIN M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ZEINEDDIN
Provider First Name:
MOHAMAD
Provider Middle Name:
A.
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
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:
1912982885
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/22/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1400 N IH 35
Provider Second Line Business Mailing Address:
SUITE 300
Provider Business Mailing Address City Name:
AUSTIN
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78701-1926
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
512-324-8300
Provider Business Mailing Address Fax Number:
512-324-8301

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7900 FM 1826
Provider Second Line Business Practice Location Address:
SUITE 170
Provider Business Practice Location Address City Name:
AUSTIN
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78737-1407
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
512-324-9250
Provider Business Practice Location Address Fax Number:
512-324-9251
Provider Enumeration Date:
12/13/2005

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: 207RC0000X , with the licence number:  H5103 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 131633314 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 131633311 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 131633310 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 8CU901 . This is a "BCBS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: P01037423 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 131633313 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 8ET557 . This is a "BCBS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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