Provider Demographics
NPI:1952305591
Name:MAHMOOD, AFTAB (MD)
Entity Type:Individual
Prefix:
First Name:AFTAB
Middle Name:
Last Name:MAHMOOD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7121 S PADRE ISLAND DR
Mailing Address - Street 2:SUITE 102
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78412-4938
Mailing Address - Country:US
Mailing Address - Phone:361-993-3456
Mailing Address - Fax:361-992-4198
Practice Address - Street 1:7121 S PADRE ISLAND DR
Practice Address - Street 2:SUITE 102
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78412-4938
Practice Address - Country:US
Practice Address - Phone:361-993-3456
Practice Address - Fax:361-992-4198
Is Sole Proprietor?:No
Enumeration Date:2005-06-10
Last Update Date:2016-04-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXM1217174400000X, 207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX175676901Medicaid
TX8D8479Medicare ID - Type Unspecified
TX175676901Medicaid