Provider Demographics
NPI:1265491724
Name:AHMED, TANVEER (MD)
Entity Type:Individual
Prefix:
First Name:TANVEER
Middle Name:
Last Name:AHMED
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 1:1000 N LEE AVE
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73102-1036
Mailing Address - Country:US
Mailing Address - Phone:405-272-6406
Mailing Address - Fax:405-272-6075
Practice Address - Street 1:3600 GASTON AVE
Practice Address - Street 2:STE 1055
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75246-1800
Practice Address - Country:US
Practice Address - Phone:214-827-0330
Practice Address - Fax:214-827-2860
Is Sole Proprietor?:No
Enumeration Date:2006-03-22
Last Update Date:2014-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK18909207RC0200X, 207RP1001X
TXM0337207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK275392YLJFMedicare PIN
G43403Medicare UPIN
238602302Medicare ID - Type Unspecified