Healthcare Provider Details

I. General information

NPI: 1245228741
Provider Name (Legal Business Name): MAHMOOD O DWEIK M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/10/2005
Last Update Date: 06/24/2024
Certification Date: 06/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 N KOBAYASHI STE 208
WEBSTER TX
77598-4841
US

IV. Provider business mailing address

PO BOX 58538
WEBSTER TX
77598-8538
US

V. Phone/Fax

Practice location:
  • Phone: 281-724-8180
  • Fax: 281-336-1171
Mailing address:
  • Phone: 281-724-1860
  • Fax: 281-724-1861

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberL8675
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License NumberL8675
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberL8675
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: