Healthcare Provider Details

I. General information

NPI: 1346173465
Provider Name (Legal Business Name): MOHAMMAD I RASOOL
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/08/2026
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4845 ALAMEDA AVE
EL PASO TX
79905-2705
US

IV. Provider business mailing address

31942 FLOWERHILL DR
LAKE ELSINORE CA
92532-2615
US

V. Phone/Fax

Practice location:
  • Phone: 915-298-5444
  • Fax:
Mailing address:
  • Phone: 840-209-5184
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberBP10099303
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: