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General NPI Number Information
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NPI Number | 1598280117
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Entity Type | Individual
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Provider Name | MOHAMMAD ALKHOMAIS BDS
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Gender | Male
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Dates
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Enumeration Date | 08/04/2017
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 4502 MEDICAL DR
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City | SAN ANTONIO
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State | TX
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Zip | 78229-4402
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Country | US
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Telephone | 210-358-4000
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Fax |
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Provider Business Mailing Address
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Address Line | 5303 HAMILTON WOLFE ROAD APT. 1415
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City | SAN ANTONIO
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State | TX
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Zip | 78229
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Country | US
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Telephone | 210-847-7324
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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 | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | ETN555
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License Number State | TX
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