=====================================================
General NPI Number Information
=====================================================
NPI Number | 1174478887
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MOHAMED SHAMIYA PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/27/2026
-----------------------------------------------------
Last Update Date | 03/03/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3417 SPECTRUM BLVD STE 200
-----------------------------------------------------
City | RICHARDSON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75082-9729
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 702-478-8819
-----------------------------------------------------
Fax | 702-478-7324
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3417 SPECTRUM BLVD STE 200
-----------------------------------------------------
City | RICHARDSON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75082-9729
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 702-478-8819
-----------------------------------------------------
Fax | 702-478-7324
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MANAGER CREDENTIALING
-----------------------------------------------------
Name | DEXTER FLOWER
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 725-666-1636
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RS0012X
-----------------------------------------------------
Taxonomy Name | Sleep Medicine (Internal Medicine) Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------