Provider Demographics
NPI:1093714628
Name:QUDDOOS, ARSHAD (MD)
Entity Type:Individual
Prefix:MR
First Name:ARSHAD
Middle Name:
Last Name:QUDDOOS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1650 W COLLEGE ST
Mailing Address - Street 2:STE. 150
Mailing Address - City:GRAPEVINE
Mailing Address - State:TX
Mailing Address - Zip Code:76051-3565
Mailing Address - Country:US
Mailing Address - Phone:817-344-3880
Mailing Address - Fax:817-344-3881
Practice Address - Street 1:1650 W COLLEGE ST
Practice Address - Street 2:STE. 150
Practice Address - City:GRAPEVINE
Practice Address - State:TX
Practice Address - Zip Code:76051-3565
Practice Address - Country:US
Practice Address - Phone:817-344-3880
Practice Address - Fax:817-344-3881
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-15
Last Update Date:2022-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY38523208M00000X
TXP8403207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200472210Medicaid
KY64077969Medicaid
IN200472210Medicaid
G71849Medicare UPIN
IN232600DMedicare PIN