Healthcare Provider Details

I. General information

NPI: 1063974822
Provider Name (Legal Business Name): JEWEL AHMED HOSPITALIST PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/02/2019
Last Update Date: 03/24/2022
Certification Date: 03/24/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6800 PRESTON RD
PLANO TX
75024-2505
US

IV. Provider business mailing address

PO BOX 8337
AMARILLO TX
79114-8337
US

V. Phone/Fax

Practice location:
  • Phone: 806-355-6593
  • Fax: 806-352-8774
Mailing address:
  • Phone: 806-355-6593
  • Fax: 806-352-8774

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MD JEWEL AHMED
Title or Position: PRESIDENT
Credential: MD
Phone: 806-282-2127