Provider Demographics
NPI:1639956840
Name:MEHBOOB AHMED MD
Entity Type:Organization
Organization Name:MEHBOOB AHMED MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:MEHBOOB
Authorized Official - Middle Name:AHMED
Authorized Official - Last Name:REHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:940-500-0888
Mailing Address - Street 1:5140 CATHEDRAL LN
Mailing Address - Street 2:
Mailing Address - City:WICHITA FALLS
Mailing Address - State:TX
Mailing Address - Zip Code:76310-1490
Mailing Address - Country:US
Mailing Address - Phone:940-500-0888
Mailing Address - Fax:940-301-3735
Practice Address - Street 1:501 MIDWESTERN PKWY E
Practice Address - Street 2:
Practice Address - City:WICHITA FALLS
Practice Address - State:TX
Practice Address - Zip Code:76302-2302
Practice Address - Country:US
Practice Address - Phone:940-500-0888
Practice Address - Fax:940-301-3735
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-11
Last Update Date:2024-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Multi-Specialty