Provider Demographics
NPI:1396046371
Name:MOHAMMAD ATHARI, MD, PA
Entity type:Organization
Organization Name:MOHAMMAD ATHARI, MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:PIPPER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-427-2700
Mailing Address - Street 1:PO BOX 935
Mailing Address - Street 2:
Mailing Address - City:BAYTOWN
Mailing Address - State:TX
Mailing Address - Zip Code:77522-0935
Mailing Address - Country:US
Mailing Address - Phone:281-427-2700
Mailing Address - Fax:281-428-2782
Practice Address - Street 1:4310 GARTH RD STE B
Practice Address - Street 2:
Practice Address - City:BAYTOWN
Practice Address - State:TX
Practice Address - Zip Code:77521-3114
Practice Address - Country:US
Practice Address - Phone:281-427-2700
Practice Address - Fax:281-428-2782
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-08
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXB20987Medicare UPIN