Individual
MOHAMMED M. BAKDASH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4515 MARSHA SHARP FWY, LUBBOCK, TX 79407-2520
(806) 744-7223
(806) 740-3325
Mailing address
4515 MARSHA SHARP FWY, LUBBOCK, TX 79407-2520
(806) 744-7223
(806) 740-3325
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
E2132
TX
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
E2132
TX
Other
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
Enumeration date
10/11/2005
Last updated
02/03/2022
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