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General NPI Number Information
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NPI Number | 1528206612
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Entity Type | Organization
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Legal Business Name | PATIENT FIRST MEDICAL GROUP PA
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Dates
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Enumeration Date | 01/27/2009
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Last Update Date | 06/30/2015
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Provider Practice Location Address
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Address Line | 7151 COLLEYVILLE BLVD SUITE 103
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City | COLLEYVILLE
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State | TX
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Zip | 76034-8029
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Country | US
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Telephone | 682-557-4042
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Fax | 817-789-4187
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Provider Business Mailing Address
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Address Line | PO BOX 96221
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City | SOUTHLAKE
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State | TX
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Zip | 76092-0127
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Country | US
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Telephone | 682-557-4042
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Fax | 817-789-4187
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Authorized Official
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Title or Position | OWNER AND CEO
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Name | MOHAMMAD N UDDIN
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Credential | M.D.
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Telephone | 682-557-4042
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | N0121
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | M8396
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License Number State | TX
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