Provider Demographics
NPI:1376763169
Name:AHMED, MOHAMMED BASHEER (MD)
Entity Type:Individual
Prefix:
First Name:MOHAMMED
Middle Name:BASHEER
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 1:10 HOME PLACE CT
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76016-3913
Mailing Address - Country:US
Mailing Address - Phone:817-907-6080
Mailing Address - Fax:817-572-4981
Practice Address - Street 1:10 HOME PLACE CT
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76016-3913
Practice Address - Country:US
Practice Address - Phone:817-907-6080
Practice Address - Fax:817-572-4981
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF08472084P0015X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0015XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychosomatic Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXC12637Medicare UPIN