Provider Demographics
NPI:1497869101
Name:MOHMAND, ASAD KHAN (MD)
Entity Type:Individual
Prefix:DR
First Name:ASAD
Middle Name:KHAN
Last Name:MOHMAND
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 1:3001 E PRESIDENT GEORGE BUSH HWY STE 210
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75082-3552
Mailing Address - Country:US
Mailing Address - Phone:469-913-9400
Mailing Address - Fax:469-913-9420
Practice Address - Street 1:3001 E PRESIDENT GEORGE BUSH HWY STE 210
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75082-3552
Practice Address - Country:US
Practice Address - Phone:469-913-9400
Practice Address - Fax:469-913-9420
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2022-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101249220207R00000X, 207R00000X
MI4301079749207R00000X, 207R00000X
TXQ3557207RI0011X, 207UN0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4739665Medicaid
MI4739665Medicaid
MI0C36082085Medicare PIN