Physician Compare National (NPI:1841458619)

HEALTHCARE PROVIDER: SAIRA BANOO MOMIN DO

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1841458619
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	1557522182
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20120409000261
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	MOMIN
	Individual professional last name
Provider First Name	SAIRA
	Individual professional first name
Provider Middle Name	BANOO
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	UNIVERSITY OF NORTH TEXAS HSC, COLLEGE OF OSTEOPATHIC MED
	Individual professional's medical school
Graduation Year	2006
	Individual professional's medical school graduation year
Primary Specialty	DERMATOLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	2020 W STATE HWY 114
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 340
	Group Practice or individual's line 2 address
City	GRAPEVINE
	Group Practice or individual's city
State	TX
	Group Practice or individual's state
Zip Code	760518650
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y