Provider Demographics
NPI:1578510863
Name:AHMED, MOHAMMED IQBAL (MD)
Entity Type:Individual
Prefix:
First Name:MOHAMMED
Middle Name:IQBAL
Last Name:AHMED
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5323 HARRY HINES BLVD
Mailing Address - Street 2:MC 9068
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75390-9068
Mailing Address - Country:US
Mailing Address - Phone:214-648-3111
Mailing Address - Fax:214-648-5461
Practice Address - Street 1:5323 HARRY HINES BLVD
Practice Address - Street 2:MC 9068
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75390-9068
Practice Address - Country:US
Practice Address - Phone:214-648-3111
Practice Address - Fax:214-648-5461
Is Sole Proprietor?:No
Enumeration Date:2006-05-30
Last Update Date:2015-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA151881207L00000X
TXQ6725207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
G34064Medicare UPIN