Basic Information
| Provider Information | |||||||||
| NPI: | 1982089009 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | OSMAN | ||||||||
| FirstName: | MOHAMED | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1325 PENNSYLVANIA AVE STE 890 | ||||||||
| Address2: | |||||||||
| City: | FORT WORTH | ||||||||
| State: | TX | ||||||||
| PostalCode: | 761042145 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8172504280 | ||||||||
| FaxNumber: | 8172504281 | ||||||||
| Practice Location | |||||||||
| Address1: | 800 5TH AVE STE 500 | ||||||||
| Address2: | |||||||||
| City: | FORT WORTH | ||||||||
| State: | TX | ||||||||
| PostalCode: | 761047304 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8172504280 | ||||||||
| FaxNumber: | 8172504281 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/30/2015 | ||||||||
| LastUpdateDate: | 02/15/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/15/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | Q7249 | TX | N | Allopathic & Osteopathic Physicians | Internal Medicine | 2084A2900X | Q7249 | TX | Y |
No ID Information.