Healthcare Provider Details

I. General information

NPI: 1619968690
Provider Name (Legal Business Name): MAZIN ABDULLAH AL SALEH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/31/2005
Last Update Date: 10/21/2024
Certification Date: 10/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19333 CLAY RD
KATY TX
77449
US

IV. Provider business mailing address

5502 1ST ST
KATY TX
77493-2472
US

V. Phone/Fax

Practice location:
  • Phone: 713-462-6565
  • Fax:
Mailing address:
  • Phone: 713-462-6565
  • Fax: 575-763-3351

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License NumberM7823
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: