Healthcare Provider Details

I. General information

NPI: 1790826923
Provider Name (Legal Business Name): AMIN AL-AHMAD MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/09/2007
Last Update Date: 04/18/2024
Certification Date: 04/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 N. IH-35, SUITE 700
AUSTIN TX
78705
US

IV. Provider business mailing address

3000 N. IH-35, SUITE 700
AUSTIN TX
78705
US

V. Phone/Fax

Practice location:
  • Phone: 512-807-3150
  • Fax: 512-458-7879
Mailing address:
  • Phone: 512-807-3150
  • Fax: 512-458-7879

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberA82897
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberP6943
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberA82897
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License NumberA82897
License Number StateCA
# 5
Primary TaxonomyY
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License NumberP6943
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: