Provider Demographics
NPI:1295020386
Name:AHMED, HASSAN (MD)
Entity type:Individual
Prefix:
First Name:HASSAN
Middle Name:
Last Name:AHMED
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 1:515 W MAYFIELD RD STE 301
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76014-2085
Mailing Address - Country:US
Mailing Address - Phone:682-306-6777
Mailing Address - Fax:682-306-6776
Practice Address - Street 1:515 W MAYFIELD RD STE 301
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76014-2085
Practice Address - Country:US
Practice Address - Phone:682-306-6777
Practice Address - Fax:682-306-6776
Is Sole Proprietor?:No
Enumeration Date:2011-06-16
Last Update Date:2022-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ0857208600000X, 2086X0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical OncologyGroup - Single Specialty
No208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200806150AMedicaid
TX340907004Medicaid
NM74753045Medicaid
TX340907003Medicaid