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General NPI Number Information
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NPI Number | 1336455260
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Entity Type | Individual
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Provider Name | OMAIR ATIQ M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/30/2010
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Last Update Date | 10/02/2025
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Provider Practice Location Address
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Address Line | 2800 E BROAD ST STE 304
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City | MANSFIELD
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State | TX
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Zip | 76063-6412
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Country | US
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Telephone | 817-477-5500
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Fax | 817-453-5503
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Provider Business Mailing Address
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Address Line | 2800 E BROAD ST STE 304
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City | MANSFIELD
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State | TX
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Zip | 76063-6412
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Country | US
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Telephone | 817-477-5500
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Fax | 817-453-5503
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | T1286
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | MD34837
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License Number State | AL
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Taxonomy #3
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | L3213R
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License Number State | AL
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