Provider Demographics
NPI:1194346585
Name:ALGHAMDI, MOHAMMED YANALLAH (MD)
Entity type:Individual
Prefix:DR
First Name:MOHAMMED
Middle Name:YANALLAH
Last Name:ALGHAMDI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5219 CITY BANK PKWY STE 35
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79407-3545
Mailing Address - Country:US
Mailing Address - Phone:806-761-0334
Mailing Address - Fax:806-785-0872
Practice Address - Street 1:3502 9TH ST STE 430
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79415-3368
Practice Address - Country:US
Practice Address - Phone:806-761-0535
Practice Address - Fax:806-761-0534
Is Sole Proprietor?:No
Enumeration Date:2020-04-27
Last Update Date:2022-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2020042555207T00000X
TXT4700207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO200095687Medicaid