Provider Demographics
NPI:1356783427
Name:JEHANARA AHMED, M.D, P.A.
Entity type:Organization
Organization Name:JEHANARA AHMED, M.D, P.A.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JEHANARA
Authorized Official - Middle Name:
Authorized Official - Last Name:AHMED
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:409-434-4069
Mailing Address - Street 1:3070 COLLEGE ST
Mailing Address - Street 2:SUITE #201
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77701-4691
Mailing Address - Country:US
Mailing Address - Phone:409-434-4069
Mailing Address - Fax:409-347-7049
Practice Address - Street 1:3070 COLLEGE ST
Practice Address - Street 2:SUITE #201
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77701-4691
Practice Address - Country:US
Practice Address - Phone:409-434-4069
Practice Address - Fax:409-347-7049
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-18
Last Update Date:2013-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM2527261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty