Organization
PELICAN MEDICAL SPECIALISTS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MOHAMMED MOIZUDDIN (DIRECTOR)
(972) 674-9910
Entity
Organization
Contact information
Practice address
931 STATE HIGHWAY 121 STE 1100, ALLEN, TX 75013-1180
(972) 674-9910
(972) 666-5166
Mailing address
1022 KENILWORTH ST, ALLEN, TX 75013-5828
(972) 674-9910
(972) 666-5166
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
405864601
—
TX
Enumeration date
09/24/2018
Last updated
12/26/2024
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