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NPI Code Detail

MEDICARE: PEARLAND NEUROLOGY SERVICES, PLLC

MEDICARE: PEARLAND NEUROLOGY SERVICES, PLLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084N0400XNeurology Physician

General Provider Information

NPI Number : 1013535020
Entity Type Code : Organization
Provider Name (Legal Business Name) : PEARLAND NEUROLOGY SERVICES, PLLC
Provider Business Mailing Address
First Line : 9923 WALKER MEADOW WAY
Second Line :
City : HOUSTON
State : TX
Zip : 77089-1559
Country : US
Telephone Number : 646-944-3784
Fax Number :
Provider Business Practice Location Address
First Line : 11914 ASTORIA BLVD STE 400
Second Line :
City : HOUSTON
State : TX
Zip : 77089-6049
Country : US
Telephone Number : 281-481-4236
Fax Number : 281-481-0448
Authorized Official
Title or Position : PHYSICIAN
Name : DR. SHAHBUDDIN MUKARDAMWALA
Credential : MD
Telephone Number : 281-481-4236
Provider Enumeration Date : 07/07/2020
Last Update Date : 07/07/2020

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Directions to “PEARLAND NEUROLOGY SERVICES, PLLC ” Practice Location

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