MD MOINUL ISLAM (NPI# 1184022758) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184022758 |
| Entity Type | Individual |
| Full Name | MD MOINUL ISLAM |
| Credential | P.A. |
| Practice Address |
6030 W. University Odessa TX 79764 |
| Mailing Address |
Po Box 2129 Odessa TX 79760-2129 |
| Practice Telephone | 4326406600 |
| Practice Fax Number | 4326404790 |
| Mailing Telephone | 4326406600 |
| Mailing Fax Number | 4326404790 |
| Enumeration Date | 2014-12-15 |
| Last Update Date | 2015-01-21 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA09504 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
6030 W. UNIVERSITY |
| City | ODESSA |
| State | TX |
| Zip Code | 79764 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710466610 | Cvs Pharmacy Inc | Durable Medical Equipment & Medical Supplies | 3050 W University Blvd, Odessa, TX 79764 | 2018-08-10 |
| 1962897405 | H-e-b, Lp | Clinical Medical Laboratory | 2501 W. University Blvd, Odessa, TX 79764 | 2015-04-01 |
| 1962618637 | D&s Residential Services | Intermediate Care Facility, Mentally Retarded | 10036 West Westland Drive, Odessa, TX 79764 | 2007-05-16 |
| 1992119838 | Gary Chase Jackson | Optometrist | 6030 W University Blvd, Odessa, TX 79764 | 2014-06-18 |
| 1609128594 | Amanda Lynn Paradeaux | Nurse Practitioner | 3001 W University Blvd, Odessa, TX 79764 | 2012-10-03 |
| 1760619498 | Cindy A Smith | Speech-Language Pathologist | 8712 Claymoor Dr, Odessa, TX 79764-1252 | 2009-06-21 |
| 1003316084 | Maranda Pina Garza | Licensed Vocational Nurse | 24 Bookins Ct, Odessa, TX 79764-1401 | 2018-02-16 |
| 1255378717 | United Supermarkets LLC | Durable Medical Equipment & Medical Supplies | 2751 N County Rd W, Odessa, TX 79764-1665 | 2006-06-01 |
| 1578112454 | Shaikat Banerjee | Pharmacist | 2751 N County Rd W, Odessa, TX 79764-1665 | 2019-09-04 |
| 1821598939 | Maichel Roshdy | Pharmacist | 2751 N County Rd W, Odessa, TX 79764-1665 | 2018-02-15 |
| Find all providers in zip 79764 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891234969 | Jesus Mendez Fuentes | Physician Assistant | 2224 Alameda Ct, Odessa, TX 79763-2273 | 2017-02-22 |
| 1649640392 | Elesea Celeste Villegas | Physician Assistant | 701 West 5th Street, Odessa, TX 79763 | 2015-10-06 |
| 1962711200 | Ramnauth Robert Ramkissoon | Physician Assistant | 1940 E 42nd St Ste B, Odessa, TX 79762-5840 | 2010-10-05 |
| 1629304811 | Erika Alfaro Salvo | Physician Assistant | 4222 Wendover Ave Ste 600, Odessa, TX 79762-5983 | 2009-10-23 |
| 1508002262 | Javier E Espinoza | Physician Assistant | 1220 W. University, Odessa, TX 79763 | 2008-12-31 |
| 1679511802 | J David Barr | Physician Assistant | 16734 Ivy Lake Dr, Odessa, FL 33556-6020 | 2006-06-02 |
| 1275171423 | Kailani Alana Lee Decock | Physician Assistant | 520 E 6th St, Odessa, TX 79761-4527 | 2019-12-18 |
| 1255986402 | Alexandra R Fierro | Physician Assistant | 720 Golder Ave, Odessa, TX 79761-4442 | 2019-08-05 |
| 1538714076 | Stephanie Renee' Powell | Physician Assistant | 520 E 6th St, Odessa, TX 79761-4527 | 2019-08-01 |
| 1699242156 | Thomas Garet Hanselman | Physician Assistant | 500 W 4th St, Odessa, TX 79761 | 2018-11-01 |
| Find all providers in ODESSA | ||||
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| 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.