Provider Demographics
NPI:1841359114
Name:ALAM, KHURSHEED (MD)
Entity type:Individual
Prefix:
First Name:KHURSHEED
Middle Name:
Last Name:ALAM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:2000 S MCCOLL RD # 152
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78503-1501
Mailing Address - Country:US
Mailing Address - Phone:956-664-8357
Mailing Address - Fax:956-322-4822
Practice Address - Street 1:208 LINDBERG AVE
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78501
Practice Address - Country:US
Practice Address - Phone:956-664-8357
Practice Address - Fax:956-322-4822
Is Sole Proprietor?:No
Enumeration Date:2006-12-06
Last Update Date:2018-08-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXL8572207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX170868707Medicaid
TX319420ZLVQOtherMEDICARE
TX8X7912OtherBLUE CROSS BLUE SHIELD
TX8ER631OtherBCBSTX
TXP01430111OtherRR MEDICARE PTAN
TX319420ZLVQMedicare PIN