MEDICARE: DR. ABDULLAH ASSER MOHAMMED

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	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	41391	TX

General Provider Information

NPI Number	:	1689409039
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ABDULLAH ASSER MOHAMMED

Provider Business Mailing Address
First Line	:	23609 CANYON GOLF RD
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78260-1671
Country	:	US
Telephone Number	:	904-903-9643
Fax Number	:

Provider Business Practice Location Address
First Line	:	3738 CIBOLO VALLEY DR
Second Line	:
City	:	CIBOLO
State	:	TX
Zip	:	78108-4072
Country	:	US
Telephone Number	:	210-343-2458
Fax Number	:

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

Provider Enumeration Date	:	09/05/2024
Last Update Date	:	03/06/2026

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