Healthcare Provider Details

I. General information

NPI: 1407217300
Provider Name (Legal Business Name): MOHAMED E TAHA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/19/2016
Last Update Date: 08/26/2025
Certification Date: 08/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1840 JOE BATTLE BLVD
EL PASO TX
79936-0962
US

IV. Provider business mailing address

1840 JOE BATTLE BLVD
EL PASO TX
79936-0962
US

V. Phone/Fax

Practice location:
  • Phone: 915-249-4344
  • Fax: 915-307-2765
Mailing address:
  • Phone: 915-249-4344
  • Fax: 915-307-2765

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD-46265
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number0101274232
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberMD-46265
License Number StateIA
# 4
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License NumberV2836
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: