Healthcare Provider Details

I. General information

NPI: 1952562407
Provider Name (Legal Business Name): RAZIUDDIN AHMED MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/18/2008
Last Update Date: 06/03/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11920 ASTORIA BLVD SUITE 320
HOUSTON TX
77089-6097
US

IV. Provider business mailing address

11920 ASTORIA BLVD SUITE 320
HOUSTON TX
77089-6097
US

V. Phone/Fax

Practice location:
  • Phone: 281-484-9369
  • Fax:
Mailing address:
  • Phone: 281-484-9369
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number51778
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberMD.203122
License Number StateLA
# 3
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberP5920
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: