Provider Demographics
NPI:1235509571
Name:AMIRDASH, AHMAD
Entity Type:Individual
Prefix:
First Name:AHMAD
Middle Name:
Last Name:AMIRDASH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1885 EL PASEO ST
Mailing Address - Street 2:138
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-3089
Mailing Address - Country:US
Mailing Address - Phone:832-889-9390
Mailing Address - Fax:
Practice Address - Street 1:9000 ALMEDA RD APT 3201
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-4327
Practice Address - Country:US
Practice Address - Phone:832-269-6250
Practice Address - Fax:832-604-4285
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-29
Last Update Date:2022-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX794504163W00000X
TXAP129602363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No163W00000XNursing Service ProvidersRegistered Nurse