Provider Demographics
NPI:1457435745
Name:AHMED, SHEIKH EJAZ (MD)
Entity Type:Individual
Prefix:DR
First Name:SHEIKH
Middle Name:EJAZ
Last Name:AHMED
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 1:1710 W 25TH ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77008-1414
Mailing Address - Country:US
Mailing Address - Phone:716-861-6758
Mailing Address - Fax:713-861-2102
Practice Address - Street 1:1710 W 25TH ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77008
Practice Address - Country:US
Practice Address - Phone:716-861-6758
Practice Address - Fax:713-861-2102
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-24
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH6759174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX40080493OtherDPS
TXH6759OtherTEXAS STATE BOARD OF MEDI
TX128483803Medicaid
TX00K99GOtherBLUE CROSS BLUE SHEILD
TX00K99GOtherBLUE CROSS BLUE SHEILD
TX00K99GOtherBLUE CROSS BLUE SHEILD
TXEO9408Medicare UPIN