Provider Demographics
NPI:1255775748
Name:AL-TAWEEL, AHMAD SAMIR (MD)
Entity type:Individual
Prefix:
First Name:AHMAD
Middle Name:SAMIR
Last Name:AL-TAWEEL
Suffix:
Gender:
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 58538
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:TX
Mailing Address - Zip Code:77598-8538
Mailing Address - Country:US
Mailing Address - Phone:281-338-4004
Mailing Address - Fax:281-332-6524
Practice Address - Street 1:530 ORCHARD ST
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:TX
Practice Address - Zip Code:77598-4110
Practice Address - Country:US
Practice Address - Phone:281-338-4004
Practice Address - Fax:281-332-6524
Is Sole Proprietor?:No
Enumeration Date:2013-04-26
Last Update Date:2025-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR4802207RI0011X, 207RC0000X, 207RC0000X
TXBP10051598207RC0000X
MO2019011613207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX384555403Medicaid