Provider Demographics
NPI:1194213082
Name:DIAB, MOHAMMAD MAJED
Entity type:Individual
Prefix:DR
First Name:MOHAMMAD
Middle Name:MAJED
Last Name:DIAB
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4212 SUMAYYAH DR
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75038-4776
Mailing Address - Country:US
Mailing Address - Phone:469-274-6301
Mailing Address - Fax:
Practice Address - Street 1:6243 RETAIL RD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-7808
Practice Address - Country:US
Practice Address - Phone:214-363-7246
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-25
Last Update Date:2018-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13702111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor