Individual
MOHAMMED WASEEM IMAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
4120 N COLLINS ST STE 100, ARLINGTON, TX 76005-4553
(817) 678-5575
Mailing address
4120 N COLLINS ST STE 100, ARLINGTON, TX 76005-4553
(817) 678-5575
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
R5274
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1003159104
COMMERCIAL INSURANCE
TX
Enumeration date
03/27/2013
Last updated
01/22/2020
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