MEDICARE: AHMAD BEDAIR AHMAD M.D.

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	208000000X	Pediatrics Physician	K9960	TX

General Provider Information

NPI Number	:	1609956515
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AHMAD BEDAIR AHMAD M.D.

Provider Business Mailing Address
First Line	:	929 N GALLOWAY AVE
Second Line	:	SUITE 121
City	:	MESQUITE
State	:	TX
Zip	:	75149-2476
Country	:	US
Telephone Number	:	972-216-1063
Fax Number	:	972-289-4559

Provider Business Practice Location Address
First Line	:	9209 ELAM RD
Second Line	:	SUITE 101
City	:	DALLAS
State	:	TX
Zip	:	75217-4179
Country	:	US
Telephone Number	:	214-391-9444
Fax Number	:	214-391-9499

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

Provider Enumeration Date	:	10/16/2006
Last Update Date	:	07/08/2007

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