Provider Demographics
NPI:1659537827
Name:AHMED, BASHIR (MD)
Entity type:Individual
Prefix:
First Name:BASHIR
Middle Name:
Last Name:AHMED
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 1:322 BASTROP BLVD
Mailing Address - Street 2:
Mailing Address - City:FAIRVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:75069-1283
Mailing Address - Country:US
Mailing Address - Phone:817-554-6808
Mailing Address - Fax:817-601-6940
Practice Address - Street 1:1820 N LAKE FOREST DR STE 300B
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75071-7653
Practice Address - Country:US
Practice Address - Phone:469-631-0935
Practice Address - Fax:214-216-0435
Is Sole Proprietor?:No
Enumeration Date:2008-08-06
Last Update Date:2025-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25IA22078002084P0800X
MO20120066532084P0800X
MS712-L2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO204344105Medicaid