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General NPI Number Information
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NPI Number | 1194213082
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Entity Type | Individual
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Provider Name | DR. MOHAMMAD MAJED DIAB
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Gender | Male
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Dates
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Enumeration Date | 04/25/2018
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Last Update Date | 04/25/2018
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Provider Practice Location Address
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Address Line | 6243 RETAIL RD
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City | DALLAS
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State | TX
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Zip | 75231-7808
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Country | US
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Telephone | 214-363-7246
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Fax |
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Provider Business Mailing Address
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Address Line | 4212 SUMAYYAH DR
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City | IRVING
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State | TX
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Zip | 75038-4776
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Country | US
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Telephone | 469-274-6301
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 13702
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License Number State | TX
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