Healthcare Provider Details

I. General information

NPI: 1245163773
Provider Name (Legal Business Name): MOHAMMED ANAS DABABO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2026
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

KING FAISAL SPECIALIST HOSPITAL & RESEARCH CENTRE DEPARTMENT OF PATHOLOGY & LABORATORY MEDICINE
RIYADH RIYADH PROVINCE
11211
SA

IV. Provider business mailing address

PO BOX 781687
SAN ANTONIO TX
78278-1687
US

V. Phone/Fax

Practice location:
  • Phone:
  • Fax:
Mailing address:
  • Phone: 469-740-7910
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ZN0500X
TaxonomyNeuropathology Physician
License NumberV3580
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code207ZP0101X
TaxonomyAnatomic Pathology Physician
License NumberV3580
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: