Provider Demographics
NPI:1013190461
Name:ANSARI, MOHAMMED ZAFER (MD)
Entity type:Individual
Prefix:
First Name:MOHAMMED
Middle Name:ZAFER
Last Name:ANSARI
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:PO BOX 16126
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77496-6126
Mailing Address - Country:US
Mailing Address - Phone:832-939-9447
Mailing Address - Fax:832-999-4322
Practice Address - Street 1:17189 I H 45 S STE 505
Practice Address - Street 2:
Practice Address - City:SHENANDOAH
Practice Address - State:TX
Practice Address - Zip Code:77385-3323
Practice Address - Country:US
Practice Address - Phone:936-270-4400
Practice Address - Fax:936-270-4401
Is Sole Proprietor?:No
Enumeration Date:2007-12-07
Last Update Date:2022-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN7053207R00000X, 207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX218234705Medicaid
TX8FG568OtherBCBS
TX8FG568OtherBCBS