Provider Demographics
NPI:1619408911
Name:BASHIR AHMED MD, PA
Entity Type:Organization
Organization Name:BASHIR AHMED MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS, BILLING
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:L
Authorized Official - Last Name:SCALLIONS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-498-9592
Mailing Address - Street 1:322 BASTROP BLVD
Mailing Address - Street 2:
Mailing Address - City:FAIRVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:75069-1283
Mailing Address - Country:US
Mailing Address - Phone:049-822-1505
Mailing Address - Fax:940-435-7059
Practice Address - Street 1:322 BASTROP BLVD
Practice Address - Street 2:
Practice Address - City:FAIRVIEW
Practice Address - State:TX
Practice Address - Zip Code:75069-1283
Practice Address - Country:US
Practice Address - Phone:049-822-1505
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-27
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty