Provider Demographics
NPI:1942647722
Name:HAIDARA, MOULAYE AHMED (MD)
Entity Type:Individual
Prefix:DR
First Name:MOULAYE
Middle Name:AHMED
Last Name:HAIDARA
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:350 E INTERSTATE 20
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76018-1119
Mailing Address - Country:US
Mailing Address - Phone:817-784-0222
Mailing Address - Fax:817-417-0981
Practice Address - Street 1:350 E INTERSTATE 20
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76018-1119
Practice Address - Country:US
Practice Address - Phone:817-784-0222
Practice Address - Fax:817-417-0981
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-03
Last Update Date:2020-04-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXR7219207W00000X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology