Healthcare Provider Details

I. General information

NPI: 1326449018
Provider Name (Legal Business Name): RAEES AHMED M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/12/2014
Last Update Date: 05/04/2020
Certification Date: 05/04/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3406 COLLEGE ST # 100
BEAUMONT TX
77701-4612
US

IV. Provider business mailing address

3406 COLLEGE ST STE 200
BEAUMONT TX
77701-4612
US

V. Phone/Fax

Practice location:
  • Phone: 409-813-1677
  • Fax: 409-951-1691
Mailing address:
  • Phone: 409-813-2332
  • Fax: 409-232-0559

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberQ1343
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberQ1343
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: