Provider Demographics
NPI:1235131319
Name:AHMAD, NABIL M (MD)
Entity Type:Individual
Prefix:
First Name:NABIL
Middle Name:M
Last Name:AHMAD
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 1:1105 N WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:TX
Mailing Address - Zip Code:77327-3732
Mailing Address - Country:US
Mailing Address - Phone:281-593-2899
Mailing Address - Fax:281-592-0479
Practice Address - Street 1:1105 N WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:TX
Practice Address - Zip Code:77327-3732
Practice Address - Country:US
Practice Address - Phone:281-593-2899
Practice Address - Fax:281-592-0479
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-02
Last Update Date:2012-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL0739207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX143927515Medicaid
TX8F8274Medicare PIN