Provider Demographics
NPI:1609956515
Name:AHMAD, AHMAD BEDAIR (MD)
Entity Type:Individual
Prefix:
First Name:AHMAD
Middle Name:BEDAIR
Last Name:AHMAD
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 1:929 N GALLOWAY AVE
Mailing Address - Street 2:SUITE 121
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75149-2476
Mailing Address - Country:US
Mailing Address - Phone:972-216-1063
Mailing Address - Fax:972-289-4559
Practice Address - Street 1:9209 ELAM RD
Practice Address - Street 2:SUITE 101
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75217-4179
Practice Address - Country:US
Practice Address - Phone:214-391-9444
Practice Address - Fax:214-391-9499
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK9960208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
H26671Medicare UPIN
00254MMedicare ID - Type Unspecified