Provider Demographics
NPI:1417443243
Name:AL DARAWSHA, MOHAMMAD (MD)
Entity type:Individual
Prefix:
First Name:MOHAMMAD
Middle Name:
Last Name:AL DARAWSHA
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4887 WILLIAMS DR STE 107
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:TX
Mailing Address - Zip Code:78633-2440
Mailing Address - Country:US
Mailing Address - Phone:512-588-7008
Mailing Address - Fax:
Practice Address - Street 1:4887 WILLIAMS DR STE 107
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:TX
Practice Address - Zip Code:78633-2440
Practice Address - Country:US
Practice Address - Phone:512-588-7008
Practice Address - Fax:888-440-2690
Is Sole Proprietor?:No
Enumeration Date:2018-07-04
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2021025596207R00000X
TXV4084207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine