Provider Demographics
NPI:1427689058
Name:MOHAMMAD, MUHIB (PHARMD)
Entity type:Individual
Prefix:
First Name:MUHIB
Middle Name:
Last Name:MOHAMMAD
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2555 95TH ST APT 1918
Mailing Address - Street 2:
Mailing Address - City:PORT ARTHUR
Mailing Address - State:TX
Mailing Address - Zip Code:77640-1688
Mailing Address - Country:US
Mailing Address - Phone:210-685-9029
Mailing Address - Fax:
Practice Address - Street 1:3590 COLLEGE ST
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77701-4614
Practice Address - Country:US
Practice Address - Phone:409-813-8452
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-02
Last Update Date:2020-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX651143336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy