Provider Demographics
NPI:1689689077
Name:RAMZAN, ZEESHAN (MD)
Entity Type:Individual
Prefix:
First Name:ZEESHAN
Middle Name:
Last Name:RAMZAN
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 1:1325 PENNSYLVANIA AVE STE 890
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76104-2145
Mailing Address - Country:US
Mailing Address - Phone:817-250-7230
Mailing Address - Fax:
Practice Address - Street 1:1325 PENNSYLVANIA AVE STE 890
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76104-2145
Practice Address - Country:US
Practice Address - Phone:817-250-7230
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2021-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP3231207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8GF869OtherBLUE CROSS BLUE SHIELD
TX283176YPGSMedicare PIN