Individual provider Active NPI

Moheb Milad, MD

  • Pediatrics Physician
  • Lubbock, TX
National Provider Identifier
1598286494
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
S5992 Issued in TX
Practice address
3601 4TH St Dept of
Lubbock, TX 79430-0002
Phone
(817) 808-0733
NPI assigned
Jun 29, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X TX
Pediatrics Physician 208000000X S5992 TX Primary

Addresses

Primary practice location

3601 4TH St Dept of
Lubbock, TX 79430-0002

Mailing address

3601 4TH Street
Department of Pediatrics
Lubbock, TX 79430
Phone (817) 808-0733

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201028001358 TX Practitioner - Pediatric Medicine 8426329087 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
S5992TXMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Special Health Resources for Texas, Incorporated CurrentSince Oct 6, 2020 Accepting new patients
Special Health Resources for Texas, Inc CurrentSince Oct 6, 2020 Accepting new patients
Special Health Resources for Texas, Incorporated Current Accepting new patients
Special Health Resources for Texas, Incorporated Past Accepting new patients
Essent PRMC LP Past Accepting new patients

Locations

2030 S High St
Longview, TX 75602
Phone (903) 234-0936

409 N 6th St
Longview, TX 75601
Phone (903) 315-5520

3150 Clarksville St
Ste 300
Paris, TX 75460
Phone (877) 785-8750

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/AFADCA
  • Direct secure messaging: moheb.milad@wchcl.eclinicaldirectplus.com

Organizations & group practices 5

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": "1498694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1598286494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3601 4TH STREET",
            "address_2": "DEPARTMENT OF PEDIATRICS",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "79430",
            "telephone_number": "817-808-0733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 4TH ST DEPT OF",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794300002",
            "telephone_number": "817-808-0733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILAD",
        "first_name": "MOHEB",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-29",
        "last_updated": "2022-07-21",
        "certification_date": "2022-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "TX",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "S5992",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lubbock, TX

Sources for this page

Verify at the official NPI Registry.