MEDICARE: DFW ADVANCED SURGICAL GROUP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208600000X	Surgery Physician

General Provider Information

NPI Number	:	1063025039
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DFW ADVANCED SURGICAL GROUP

Provider Business Mailing Address
First Line	:	PO BOX 120969
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76012-0969
Country	:	US
Telephone Number	:	817-332-0788
Fax Number	:

Provider Business Practice Location Address
First Line	:	909 9TH AVE STE 401
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76104-3918
Country	:	US
Telephone Number	:	817-332-0788
Fax Number	:	817-332-0787

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. MOHAMAD SAAD
Credential	:	DO
Telephone Number	:	917-332-0788

Provider Enumeration Date	:	08/28/2020
Last Update Date	:	08/28/2020

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