Provider Demographics
NPI:1699003962
Name:NISAR AHMED M D P A
Entity Type:Organization
Organization Name:NISAR AHMED M D P A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NISAR
Authorized Official - Middle Name:
Authorized Official - Last Name:AHMED
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-520-6010
Mailing Address - Street 1:1200 BINZ ST STE 1240
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77004-6927
Mailing Address - Country:US
Mailing Address - Phone:713-520-6010
Mailing Address - Fax:713-520-6012
Practice Address - Street 1:1200 BINZ ST STE 1240
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77004-6927
Practice Address - Country:US
Practice Address - Phone:713-520-6010
Practice Address - Fax:713-520-6012
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-25
Last Update Date:2009-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE2120174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty