Healthcare Provider Details

I. General information

NPI: 1700813383
Provider Name (Legal Business Name): DAUD H ASHAI M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/27/2006
Last Update Date: 12/20/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 COLLEGE AVENUE STE A
FORT WORTH TX
76104-3013
US

IV. Provider business mailing address

1001 COLLEGE AVENUE STE A
FORT WORTH TX
76104-3013
US

V. Phone/Fax

Practice location:
  • Phone: 817-336-6000
  • Fax: 817-336-2072
Mailing address:
  • Phone: 817-336-6000
  • Fax: 817-336-2072

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberK2404
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: