Basic Information
| Provider Information | |||||||||
| NPI: | 1518254309 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WAHED | ||||||||
| FirstName: | MOHAMMED | ||||||||
| MiddleName: | AMER | ||||||||
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| Credential: | M.D. | ||||||||
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| OtherLastName: | WAHED | ||||||||
| OtherFirstName: | MD. | ||||||||
| OtherMiddleName: | AMER | ||||||||
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| OtherCredential: | M.D. | ||||||||
| OtherLastNameType: | 2 | ||||||||
| Mailing Information | |||||||||
| Address1: | PO BOX 910 | ||||||||
| Address2: | |||||||||
| City: | GREENVILLE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 754030910 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7135005301 | ||||||||
| FaxNumber: | 7135000732 | ||||||||
| Practice Location | |||||||||
| Address1: | 6411 FANNIN ST | ||||||||
| Address2: | DEPT. OF PATHOLOGY | ||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770301501 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7135005301 | ||||||||
| FaxNumber: | 7135000732 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/30/2011 | ||||||||
| LastUpdateDate: | 06/30/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207ZP0102X | N4829 | TX | Y | Allopathic & Osteopathic Physicians | Pathology | Anatomic Pathology & Clinical Pathology |
No ID Information.