Provider Demographics
NPI:1164464152
Name:MAHMOOD, KHALID (MD)
Entity Type:Individual
Prefix:DR
First Name:KHALID
Middle Name:
Last Name:MAHMOOD
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:PO BOX 911230
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75391-1230
Mailing Address - Country:US
Mailing Address - Phone:972-997-8000
Mailing Address - Fax:972-437-9605
Practice Address - Street 1:501 W MEDICAL CENTER BLVD
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:TX
Practice Address - Zip Code:77598-4219
Practice Address - Country:US
Practice Address - Phone:281-332-7505
Practice Address - Fax:281-332-7616
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2018-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL7802207RH0003X, 207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
No207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX164731503Medicaid
TX8R1593OtherBLUE CROSS OF TEXAS
TX164731508Medicaid
TX164731509Medicaid
TX164731505Medicaid
TX164731508Medicaid
TX164731504Medicaid
TX8R1593OtherBLUE CROSS OF TEXAS
TX164731505Medicaid
TX164731504Medicaid
TX164731502Medicaid
TX8D1189Medicare PIN
TX8R1593OtherBLUE CROSS OF TEXAS
TX164731508Medicaid
TX164731503Medicaid
TX8F0568Medicare PIN
TX8G0537Medicare PIN