Healthcare Provider Details
I. General information
NPI: 1659537827
Provider Name (Legal Business Name): BASHIR AHMED M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 08/06/2008
Last Update Date: 07/18/2025
Certification Date: 07/18/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1820 N LAKE FOREST DR STE 300B
MCKINNEY TX
75071-7653
US
IV. Provider business mailing address
322 BASTROP BLVD
FAIRVIEW TX
75069-1283
US
V. Phone/Fax
- Phone: 469-631-0935
- Fax: 214-216-0435
- Phone: 817-554-6808
- Fax: 817-601-6940
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | 25IA2207800 |
| License Number State | NJ |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | 2012006653 |
| License Number State | MO |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | 712-L |
| License Number State | MS |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | Q4003 |
| License Number State | TX |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: