Individual
MOHAMMED MAHMOOD AL AZZAWI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BDS, MS, MS, PHD
Contact information
Practice address
4179 DOWLEN RD, BEAUMONT, TX 77706-6852
(916) 595-3187
Mailing address
13210 LAGUNA SHORES DR, PEARLAND, TX 77584-6748
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
0401416654
VA
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
35480
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
35480
DENTAL LICENCE
TX
Enumeration date
07/24/2019
Last updated
04/02/2021
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