Provider Demographics
NPI:1558328229
Name:MOHMAND, HASHIM KHAN (MD)
Entity type:Individual
Prefix:
First Name:HASHIM
Middle Name:KHAN
Last Name:MOHMAND
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1420 VICEROY DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75235-2208
Mailing Address - Country:US
Mailing Address - Phone:214-358-2300
Mailing Address - Fax:214-366-6127
Practice Address - Street 1:530 CLARA BARTON BLVD
Practice Address - Street 2:STE 150
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75042-5703
Practice Address - Country:US
Practice Address - Phone:214-358-2300
Practice Address - Fax:214-579-6701
Is Sole Proprietor?:No
Enumeration Date:2006-04-27
Last Update Date:2024-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN7724207RN0300X, 208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200515440Medicaid
KY64098551Medicaid
OH2545366Medicaid
OHMO4156501Medicare PIN
I28344Medicare UPIN
OH2545366Medicaid