Provider Demographics
NPI:1821094616
Name:AHMED, SHAKIL (MD)
Entity Type:Individual
Prefix:DR
First Name:SHAKIL
Middle Name:
Last Name:AHMED
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 1:820 W ARAPAHO RD
Mailing Address - Street 2:STE 200
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-4065
Mailing Address - Country:US
Mailing Address - Phone:972-498-4500
Mailing Address - Fax:972-680-9147
Practice Address - Street 1:820 W ARAPAHO RD
Practice Address - Street 2:STE 200
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-4065
Practice Address - Country:US
Practice Address - Phone:972-498-4500
Practice Address - Fax:972-680-9147
Is Sole Proprietor?:No
Enumeration Date:2005-06-26
Last Update Date:2013-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK9476207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX042165306Medicaid
TX042165305Medicaid
TX042165306Medicaid
TX8426B6Medicare PIN
TXTXB145824Medicare PIN
TX042165305Medicaid
TX8J0378Medicare PIN