Healthcare Provider Details

I. General information

NPI: 1962473660
Provider Name (Legal Business Name): MOHAMMAD A KHALIL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/30/2006
Last Update Date: 07/13/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

321 N HIGHLAND AVE STE 105
SHERMAN TX
75092-7371
US

IV. Provider business mailing address

15177 SNOWSHILL DR
FRISCO TX
75035-7243
US

V. Phone/Fax

Practice location:
  • Phone: 903-347-0001
  • Fax: 903-347-0002
Mailing address:
  • Phone: 903-347-0001
  • Fax: 903-347-0002

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number51306-020
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number51306-020
License Number StateWI
# 3
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberK7566
License Number StateTX
# 4
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number51306-020
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: