Provider Demographics
NPI:1922399724
Name:MAHNOOR, REESHA (MD)
Entity Type:Individual
Prefix:DR
First Name:REESHA
Middle Name:
Last Name:MAHNOOR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12221 MERIT DR.
Mailing Address - Street 2:SUITE 1500
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75251
Mailing Address - Country:US
Mailing Address - Phone:214-217-1911
Mailing Address - Fax:214-217-1920
Practice Address - Street 1:1400 COULTER STREET
Practice Address - Street 2:TTUHSC,
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79106-1708
Practice Address - Country:US
Practice Address - Phone:806-354-5417
Practice Address - Fax:806-351-3787
Is Sole Proprietor?:No
Enumeration Date:2011-04-27
Last Update Date:2015-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
TXP8272207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program