Provider Demographics
NPI:1235134420
Name:HASHIM, AHAMMED (MD)
Entity Type:Individual
Prefix:
First Name:AHAMMED
Middle Name:
Last Name:HASHIM
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 631310
Mailing Address - Street 2:
Mailing Address - City:NACOGDOCHES
Mailing Address - State:TX
Mailing Address - Zip Code:75963-1310
Mailing Address - Country:US
Mailing Address - Phone:936-585-4646
Mailing Address - Fax:
Practice Address - Street 1:1209 N MOUND ST
Practice Address - Street 2:
Practice Address - City:NACOGDOCHES
Practice Address - State:TX
Practice Address - Zip Code:75961-4028
Practice Address - Country:US
Practice Address - Phone:936-585-4646
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-06-15
Last Update Date:2011-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN2558207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
I04026Medicare UPIN
290000384Medicare ID - Type Unspecified