# MOHAMMED M. BAKDASH

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1629066964
- **Gender:** Man
- **Credential:** M.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | E2132 | TX | — |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | E2132 | TX | Yes |

## Other

- **Enumeration date:** 10/11/2005
- **Last updated:** 02/03/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 107931110 | FIRSTCARE (GRACE CLINIC) | TX |
| 05 | — | 1286387 08 | — | TX |
| 01 | — | 4393386 | AETNA | TX |
| 01 | — | 8V8694 | BCBS-TX (GRACE CLINIC DR) | TX |