Basic Information
| Provider Information | |||||||||
| NPI: | 1396151056 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MAHDAWI | ||||||||
| FirstName: | REEM | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | AL-MAHDAWI | ||||||||
| OtherFirstName: | REEM | ||||||||
| OtherMiddleName: | TARIQ JASSIM | ||||||||
| OtherNamePrefix: | |||||||||
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| OtherCredential: | |||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 909 FROSTWOOD DR STE 1.100 | ||||||||
| Address2: | |||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770242301 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7133385519 | ||||||||
| FaxNumber: | 7137043086 | ||||||||
| Practice Location | |||||||||
| Address1: | 23900 KATY FWY | ||||||||
| Address2: | |||||||||
| City: | KATY | ||||||||
| State: | TX | ||||||||
| PostalCode: | 774941323 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2816448111 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/02/2014 | ||||||||
| LastUpdateDate: | 01/27/2022 | ||||||||
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| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | F | ||||||||
| AuthorizedOfficialLastName: | |||||||||
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| AuthorizedOfficialTitleorPosition: | |||||||||
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| IsSoleProprietor: | N | ||||||||
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| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | 01/27/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 62153 | MN | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | S5007 | TX | N | Allopathic & Osteopathic Physicians | Internal Medicine | 208M00000X | 274322 | MA | N | Allopathic & Osteopathic Physicians | Hospitalist | 208M00000X | S5007 | TX | Y | Allopathic & Osteopathic Physicians | Hospitalist |
No ID Information.