Provider Demographics
NPI:1245421429
Name:AHMED, AMMAR MOIN (MD)
Entity Type:Individual
Prefix:DR
First Name:AMMAR
Middle Name:MOIN
Last Name:AHMED
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1601 RIO GRANDE ST
Mailing Address - Street 2:SUITE 340
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78701-1137
Mailing Address - Country:US
Mailing Address - Phone:512-324-8960
Mailing Address - Fax:512-324-8962
Practice Address - Street 1:313 E 12TH ST
Practice Address - Street 2:SUITE 101
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78701-1954
Practice Address - Country:US
Practice Address - Phone:512-324-9650
Practice Address - Fax:512-324-9653
Is Sole Proprietor?:No
Enumeration Date:2007-08-05
Last Update Date:2013-01-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXBP10029412207RA0000X
TXN4239207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207RA0000XAllopathic & Osteopathic PhysiciansInternal MedicineAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8CT175OtherBCBS
TX283582902Medicaid
TX283582901Medicaid
TXTXB132359Medicare PIN
TXTXB132358Medicare PIN