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General NPI Number Information
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NPI Number | 1497192074
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Entity Type | Individual
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Provider Name | MUDASSAR AHMAD M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/23/2013
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Last Update Date | 07/31/2019
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Provider Practice Location Address
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Address Line | 18220 STATE HIGHWAY 249
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City | HOUSTON
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State | TX
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Zip | 77070-4347
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Country | US
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Telephone | 713-363-9678
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Fax |
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Provider Business Mailing Address
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Address Line | 15150 BLANCO RD APT 3219
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City | SAN ANTONIO
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State | TX
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Zip | 78232-3314
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Country | US
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Telephone | 240-587-1317
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Fax |
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | R1683
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | R1683
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | 57701
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License Number State | SD
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Taxonomy #4
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Taxonomy Code | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number | R1683
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License Number State | TX
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