Healthcare Provider Details

I. General information

NPI: 1316171705
Provider Name (Legal Business Name): AHMAD TALIB MUHAMMAD M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: AHMED TALIB MOHAMEED

II. Dates (important events)

Enumeration Date: 05/13/2009
Last Update Date: 03/18/2022
Certification Date: 03/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9544 RICHMOND AVE STE F
HOUSTON TX
77063-3834
US

IV. Provider business mailing address

9544 RICHMOND AVE STE F
HOUSTON TX
77063-3834
US

V. Phone/Fax

Practice location:
  • Phone: 713-426-0027
  • Fax: 713-526-1422
Mailing address:
  • Phone: 713-426-0027
  • Fax: 713-526-1422

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License NumberQ7086
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code246ZS0410X
TaxonomySurgical Technologist
License Number08-227
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberQ7086
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: