Healthcare Provider Details

I. General information

NPI: 1558565705
Provider Name (Legal Business Name): PREMIER CARDIOVASCULAR CONSULTANTS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/12/2007
Last Update Date: 08/29/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 E HOUSTON ST SUITE C
CLEVELAND TX
77327-4602
US

IV. Provider business mailing address

1105 N WASHINGTON AVE
CLEVELAND TX
77327-3732
US

V. Phone/Fax

Practice location:
  • Phone: 281-593-3389
  • Fax: 281-592-0479
Mailing address:
  • Phone: 281-593-3389
  • Fax: 281-592-0479

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberL0739
License Number StateTX

VIII. Authorized Official

Name: DR. NABIL MAHMOOD AHMAD
Title or Position: PRESIDENT
Credential: MD
Phone: 281-593-2899