MR. MEHBOOB S QASSAM (NPI# 1508821216) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508821216 |
| Entity Type | Individual |
| Full Name | MR. MEHBOOB S QASSAM |
| Credential | M.D. |
| Practice Address |
11801 S. Freeway Fort Worth TX 76134 |
| Mailing Address |
6116 Laurel Valley Ct Fort Worth TX 76132-4467 |
| Practice Telephone | 8172939110 |
| Enumeration Date | 2006-04-18 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 207PE0004X |
Emergency Medicine Specialization: Emergency Medical Services |
J4972 | TX | Allopathic & Osteopathic Physicians |
| X | 207R00000X | Internal Medicine | J4972 | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 137389608 | 05 |
| Street Address |
11801 S. FREEWAY |
| City | FORT WORTH |
| State | TX |
| Zip Code | 76134 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902861644 | Antonio Eduardo Martin | Anesthesiology | 11801 S. Freeway, Huguley Memorial Hospital, Fort Worth, TX 76115 | 2006-04-18 |
| 1851356471 | Harold E Johnson | Emergency Medicine | 11801 S. Freeway, Fort Worth, TX 76134 | 2006-04-18 |
| 1023073665 | Karim S Jamal | Emergency Medicine | 11801 S. Freeway, Fort Worth, TX 76134 | 2006-04-18 |
| 1609831239 | Eugene R Osborn | Emergency Medicine | 11801 S. Freeway, Fort Worth, TX 76134 | 2006-04-18 |
| 1689639221 | Frank J Papa | Emergency Medicine | 11801 S. Freeway, Fort Worth, TX 76134 | 2006-04-18 |
| 1902861610 | John K Griswell | Emergency Medicine | 11801 S. Freeway, Fort Worth, TX 76134 | 2006-04-18 |
| 1083679799 | Dennis R Haslam Jr. | Emergency Medicine | 11801 S. Freeway, Fort Worth, TX 76134 | 2006-04-18 |
| 1205891835 | Daniel Scott Piotrowski | Emergency Medicine | 11801 S. Freeway, Fort Worth, TX 76134 | 2006-04-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649524125 | En'style Hair & Total Image Studio | Prosthetic/Orthotic Supplier | 1173 Sunderland Lane, Fort Worth, TX 76134 | 2012-11-05 |
| 1144479601 | Vidya Sri Suri | Dentist | 1900 W Everman Parkway #130, Fort Worth, TX 76134 | 2008-09-09 |
| 1003004490 | Richard Irwin Marks | Dentist | 105 Bellvue Dr, Fort Worth, TX 76134 | 2007-10-10 |
| 1477518009 | Peter D Hayward | Emergency Medicine | 11801 S Freeway, Fort Worth, TX 76134 | 2006-04-18 |
| 1013439686 | Serenity Square L.l.c | Respite Care | 1121 Kielder Cir, Ft. Worth, TX 76134 | 2017-07-14 |
| 1154869717 | Sycamore Dental | Dentist | 1900 W Everman Parkway #130, Fort Worth, TX 76134 | 2017-02-03 |
| 1346265071 | Huguley Emergency Physicians, LLP | Emergency Medicine | 11801 S Freeway, Fort Worth, TX 76134 | 2006-07-13 |
| 1154817690 | Beatrice Linda Salzido | Licensed Vocational Nurse | 5709 Westcrest Dr, Fort Worth, TX 76134-1029 | 2018-07-09 |
| 1134737448 | Jacqueline Marie Martinez | Specialist/Technologist | 1605 Grady Lee St, Fort Worth, TX 76134-1115 | 2020-07-22 |
| 1174538011 | Edgecliff Village Ems | Ambulance | 1605 Edgecliff Rd, Fort Worth, TX 76134-1121 | 2006-07-29 |
| Find all providers in zip 76134 | ||||
| Taxonomy Code | 207PE0004X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| Specialization | Emergency Medical Services |
| An emergency medicine physician who specializes in non-hospital based emergency medical services (e.g., disaster site, accident scene, transport vehicle, etc.) to provide pre-hospital assessment, treatment, and transport patients. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) is issued by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740233543 | Michael L. Richey | Emergency Medicine | 7633 Bellaire Dr S Ste 117, Fort Worth, TX 76132-4311 | 2006-05-19 |
| 1477518009 | Peter D Hayward | Emergency Medicine | 11801 S Freeway, Fort Worth, TX 76134 | 2006-04-18 |
| 1225431588 | Cec Oakmont Er Physicians Pllc | Emergency Medicine | 7445 Oakmont Blvd, Fort Worth, TX 76132-3905 | 2014-10-01 |
| 1265852552 | Layton Kayle Hamblin | Emergency Medicine | 1500 S Main St, Fort Worth, TX 76104-4917 | 2014-04-24 |
| 1760552616 | Yiling Kao | Emergency Medicine | 7100 Oakmont Blvd, Fort Worth, TX 76132-3900 | 2006-11-08 |
| 1346265071 | Huguley Emergency Physicians, LLP | Emergency Medicine | 11801 S Freeway, Fort Worth, TX 76134 | 2006-07-13 |
| 1255377081 | Paul A Haberer | Emergency Medicine | 4060 Sandshell Dr, Fort Worth, TX 76137-2422 | 2006-06-21 |
| 1891743860 | David Fletcher | Emergency Medicine | 1301 Pennsylvania Ave, Fort Worth, TX 76104-2122 | 2006-05-04 |
| 1851356471 | Harold E Johnson | Emergency Medicine | 11801 S. Freeway, Fort Worth, TX 76134 | 2006-04-18 |
| 1023073665 | Karim S Jamal | Emergency Medicine | 11801 S. Freeway, Fort Worth, TX 76134 | 2006-04-18 |
| Find all providers in FORT WORTH | ||||
| City | FORT WORTH |
| Zip Code | 76134 |
Please comment or provide details below to improve the information on MR. MEHBOOB S QASSAM.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.