Healthcare Provider Details

I. General information

NPI: 1689246340
Provider Name (Legal Business Name): FULL SPECTRUM MEDICAL PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2021
Last Update Date: 01/11/2024
Certification Date: 01/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4301 SATURN RD STE 201
GARLAND TX
75041-5351
US

IV. Provider business mailing address

6018 TUCKERS PL
ROWLETT TX
75089-7125
US

V. Phone/Fax

Practice location:
  • Phone: 469-814-9872
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. MAHDI AWWAD
Title or Position: CO-OWNER
Credential: MD
Phone: 469-348-4124