MEDICARE: TARIQ MEHMOOD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	1191302	TX

General Provider Information

NPI Number	:	1265227409
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TARIQ MEHMOOD

Provider Business Mailing Address
First Line	:	2756 KEOKUK ST
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76179-2423
Country	:	US
Telephone Number	:	732-648-9727
Fax Number	:

Provider Business Practice Location Address
First Line	:	2756 KEOKUK ST
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76179-2423
Country	:	US
Telephone Number	:	817-839-2924
Fax Number	:	817-396-6751

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/09/2025
Last Update Date	:	02/21/2026

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Directions to “ TARIQ MEHMOOD ” Practice Location

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