Healthcare Provider Details

I. General information

NPI: 1265666036
Provider Name (Legal Business Name): MD JEWEL AHMED MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/08/2009
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

3532 DRIPPING SPRINGS DR
PLANO TX
75025-6804
US

V. Phone/Fax

Practice location:
  • Phone: 806-355-6593
  • Fax: 806-352-8774
Mailing address:
  • Phone: 806-282-2127
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberP2181
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberP2181
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: