Provider Demographics
NPI:1316974249
Name:MOHAMMED, NAZIMUDDIN T (MD)
Entity type:Individual
Prefix:DR
First Name:NAZIMUDDIN
Middle Name:T
Last Name:MOHAMMED
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:11500 STATE HIGHWAY 121 STE 930
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75035-9347
Mailing Address - Country:US
Mailing Address - Phone:469-200-4093
Mailing Address - Fax:469-200-4079
Practice Address - Street 1:11500 STATE HIGHWAY 121 STE 510
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75035-9348
Practice Address - Country:US
Practice Address - Phone:469-200-4093
Practice Address - Fax:469-200-4079
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-27
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR15862084P0800X, 2084P0800X
IL036-1227812084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
I23987Medicare UPIN