Provider Demographics
NPI:1508812595
Name:ALMASI, MASOUD (MD)
Entity Type:Individual
Prefix:DR
First Name:MASOUD
Middle Name:
Last Name:ALMASI
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 1:4200 S LAKE FOREST DR STE 100
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070-7346
Mailing Address - Country:US
Mailing Address - Phone:214-592-0356
Mailing Address - Fax:214-504-9385
Practice Address - Street 1:4510 MEDICAL CENTER DR STE 209
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75069-1602
Practice Address - Country:US
Practice Address - Phone:214-592-0356
Practice Address - Fax:214-504-9385
Is Sole Proprietor?:No
Enumeration Date:2006-05-25
Last Update Date:2022-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM9795208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
0-425-814-1OtherECFMG
TX195191503OtherTPI
NJ6565808Medicaid
TXM9795OtherLICENCENSE
NJAL788683Medicare ID - Type Unspecified
TX195191503OtherTPI