Healthcare Provider Details

I. General information

NPI: 1093714628
Provider Name (Legal Business Name): ARSHAD QUDDOOS M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/15/2005
Last Update Date: 04/08/2022
Certification Date: 04/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1650 W COLLEGE ST STE. 150
GRAPEVINE TX
76051-3565
US

IV. Provider business mailing address

1650 W COLLEGE ST STE. 150
GRAPEVINE TX
76051-3565
US

V. Phone/Fax

Practice location:
  • Phone: 817-344-3880
  • Fax: 817-344-3881
Mailing address:
  • Phone: 817-344-3880
  • Fax: 817-344-3881

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number38523
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberP8403
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: