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General NPI Number Information
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NPI Number | 1891172839
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Entity Type | Individual
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Provider Name | AMANDA ELISE MOHAMMED-STRAIT MD
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Gender | Female
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Dates
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Enumeration Date | 04/29/2015
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Last Update Date | 11/13/2024
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Provider Practice Location Address
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Address Line | 1515 S BUCKNER BLVD
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City | DALLAS
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State | TX
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Zip | 75217-1760
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Country | US
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Telephone | 214-305-7065
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Fax | 469-574-0383
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Provider Business Mailing Address
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Address Line | 30 W MONROE ST STE 1200
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City | CHICAGO
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State | IL
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Zip | 60603-2420
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Country | US
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Telephone | 312-733-9730
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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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 | R8060
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License Number State | TX
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