MEDICARE: DR. AWAB KAMAL MAHMOUD ELNAEEM M.B.,B.S.

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	2084N0400X	Neurology Physician	74420	TN
2	2084V0102X	Vascular Neurology Physician	74420	TN
3	2084N0400X	Neurology Physician	BP10074415	TX

General Provider Information

NPI Number	:	1518639657
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AWAB KAMAL MAHMOUD ELNAEEM M.B.,B.S.

Provider Business Mailing Address
First Line	:	301 UNIVERSITY BLVD # 9.128
Second Line	:
City	:	GALVESTON
State	:	TX
Zip	:	77555-0539
Country	:	US
Telephone Number	:	409-772-8031
Fax Number	:

Provider Business Practice Location Address
First Line	:	920 MADISON AVENUE SUITE 447
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38163-0539
Country	:	US
Telephone Number	:	409-772-8031
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/28/2021
Last Update Date	:	05/27/2026

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