Provider Demographics
NPI:1720079312
Name:ZAMAN, MOHAMMAD YASAR (MD)
Entity Type:Individual
Prefix:
First Name:MOHAMMAD
Middle Name:YASAR
Last Name:ZAMAN
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 1:1105 CENTRAL EXPY N STE 235
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75013-6135
Mailing Address - Country:US
Mailing Address - Phone:972-747-6042
Mailing Address - Fax:972-747-6043
Practice Address - Street 1:1105 CENTRAL EXPY N STE 235
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75013-6135
Practice Address - Country:US
Practice Address - Phone:972-747-6042
Practice Address - Fax:972-747-6043
Is Sole Proprietor?:No
Enumeration Date:2005-11-02
Last Update Date:2013-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM5989208M00000X, 207R00000X
NM20030365207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR178751001Medicaid
TXP00830985OtherRAILROAD MEDICARE
OK200267700AMedicaid
TX191922704Medicaid
TX8AN229OtherBCBS OF TEXAS
TX8L17855Medicare PIN
AR178751001Medicaid
TX290868YKP5Medicare PIN