Individual ProviderMohamad AbdallaAnesthesiologyAllopathic & Osteopathic PhysiciansPractice Address12222 Merit Dr Ste 600, Dallas, TX 75251-3294(972) 715-5000(972) 233-1999PECOS EnrollmentBased on the most recent information from CMS, provider Mohamad Abdalla is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 34 days ago.Profile DetailsProvider ID1073680963Provider TypeIndividualFull NameAbdalla, MohamadCredentialMDGenderMaleSole ProprietorNoEnumeration Date11/29/2006Last Updated7/27/2022Contact InformationPractice LocationPractice Address12222 Merit Dr Ste 600, Dallas, TX 75251-3294Phone(972) 715-5000Fax(972) 715-9976Mailing LocationMailing AddressPO Box 840853, Dallas, TX 75284-0853Phone(972) 233-1999Fax(972) 233-3666Provider TaxonomiesCodeDescriptionLicenseCode207L00000XPrimaryDescriptionAnesthesiologyAllopathic & Osteopathic PhysiciansLicenseP8104TexasCode207L00000XDescriptionAnesthesiologyAllopathic & Osteopathic PhysiciansLicenseA77865CaliforniaProvider IdentifiersIDDescriptionIssuerID8ED613DescriptionOtherIssuerBLUE CROSS BLUE SHIELDTexas