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Individual

DR. MOHANNAD BASEM BISHARAT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
3023 PERRYTON PKWY, SUITE 101, PAMPA, TX 79065-2821
(806) 663-5523
(806) 669-1491
Mailing address
3023 PERRYTON PKWY, SUITE 101, PAMPA, TX 79065-2821
(806) 663-5523
(806) 669-1491

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
25MA08532200
NJ
207RI0011X
Interventional Cardiology Physician
Primary
Q3484
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
345256701
TX
Enumeration date
01/08/2010
Last updated
08/03/2016
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