Provider Demographics
NPI:1932531019
Name:AHMAD, SHABBIR (NP)
Entity Type:Individual
Prefix:
First Name:SHABBIR
Middle Name:
Last Name:AHMAD
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 W INTERSTATE 20
Mailing Address - Street 2:SUITE 1
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76017-5851
Mailing Address - Country:US
Mailing Address - Phone:817-784-8268
Mailing Address - Fax:817-417-1151
Practice Address - Street 1:801 W INTERSTATE 20
Practice Address - Street 2:SUITE 1
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76017-5851
Practice Address - Country:US
Practice Address - Phone:817-784-8268
Practice Address - Fax:817-417-1151
Is Sole Proprietor?:No
Enumeration Date:2013-07-31
Last Update Date:2014-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX725780363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP01318238OtherRAILROAD MEDICARE
TXP01318238OtherRAILROAD MEDICARE