Healthcare Provider Details

I. General information

NPI: 1124391198
Provider Name (Legal Business Name): MOHAMED AHMED KHALIL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/21/2012
Last Update Date: 02/19/2026
Certification Date: 02/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

905 W MEDICAL CENTER BLVD STE 301
WEBSTER TX
77598-4009
US

IV. Provider business mailing address

PO BOX 58538
WEBSTER TX
77598-8538
US

V. Phone/Fax

Practice location:
  • Phone: 281-724-8334
  • Fax:
Mailing address:
  • Phone: 281-724-8334
  • Fax: 281-724-0490

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code204C00000X
TaxonomySports Medicine (Neuromusculoskeletal Medicine) Physician
License NumberE8018
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberE8018
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: