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General NPI Number Information
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NPI Number | 1336436377
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Entity Type | Individual
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Provider Name | MOHAMAD EZZELDIN MD
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Gender | Male
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Dates
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Enumeration Date | 06/28/2011
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Last Update Date | 02/04/2022
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Provider Practice Location Address
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Address Line | 22999 HIGHWAY 59 N STE 220
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City | KINGWOOD
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State | TX
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Zip | 77339-4440
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Country | US
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Telephone | 281-312-6457
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Fax |
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Provider Business Mailing Address
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Address Line | 2200 JEFFERSON AVE FL 5
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City | TOLEDO
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State | OH
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Zip | 43604-7102
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Country | US
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Telephone |
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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 | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 35129899
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number | S0875
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License Number State | TX
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