MEDICARE: MOHAMMED OMEISHI DMD

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
1	122300000X	Dentist	40103	TX

General Provider Information

NPI Number	:	1295350213
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MOHAMMED OMEISHI DMD

Provider Business Mailing Address
First Line	:	5805 E SAM HOUSTON PKWY N
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77049-2504
Country	:	US
Telephone Number	:	224-999-4928
Fax Number	:

Provider Business Practice Location Address
First Line	:	5805 E SAM HOUSTON PKWY N
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77049-2504
Country	:	US
Telephone Number	:	224-999-4928
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/15/2020
Last Update Date	:	10/10/2025

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