Individual provider Active NPI

Mohd Al Alam, LSA

  • Surgical Physician Assistant
  • Sugar Land, TX
National Provider Identifier
1487772901
Registry record updated Dec 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
Practice address
1234 Ancrum Hill LN
Sugar Land, TX 77479-6709
Phone
(713) 816-8219
NPI assigned
Mar 26, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Assistant 246ZC0007X SA00309 TX
Surgical Technologist 246ZS0410X 03-117 TX
Surgical Technologist 246ZS0410X SA00309 TX
Surgical Physician Assistant 363AS0400X Primary

Addresses

Primary practice location

1234 Ancrum Hill LN
Sugar Land, TX 77479-6709

Mailing address

1234 Ancrum Hill LN
Sugar Land, TX 77479-6709
Phone (713) 816-8219

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SA00309TXMDSurgical Assistant
03-117TXMDSurgical Technologist

Practice roles

OrganizationSpecialtyStatusNew patients
B & K Enterprises Inc. Surgical CurrentSince Dec 5, 2021 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638489600000",
    "number": "1487772901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1234 ANCRUM HILL LN",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774796709",
            "telephone_number": "713-816-8219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1234 ANCRUM HILL LN",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774796709",
            "telephone_number": "713-816-8219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AL ALAM",
        "first_name": "MOHD",
        "credential": "LSA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-26",
        "last_updated": "2021-12-03",
        "certification_date": "2021-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZC0007X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Assistant",
            "state": "TX",
            "license": "SA00309",
            "primary": false
        },
        {
            "code": "246ZS0410X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Technologist",
            "state": "TX",
            "license": "03-117",
            "primary": false
        },
        {
            "code": "246ZS0410X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Technologist",
            "state": "TX",
            "license": "SA00309",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sugar Land, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.