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General NPI Number Information
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NPI Number | 1649280777
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Entity Type | Individual
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Provider Name | TANVIR AHMAD MD
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Gender | Male
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Dates
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Enumeration Date | 08/09/2006
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Last Update Date | 07/10/2017
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Provider Practice Location Address
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Address Line | 2501 ELK TRL
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City | PLANO
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State | TX
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Zip | 75025-6022
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Country | US
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Telephone | 509-594-6119
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Fax |
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Provider Business Mailing Address
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Address Line | 615 S HIGHWAY 78 STE 100
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City | WYLIE
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State | TX
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Zip | 75098-4099
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Country | US
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Telephone | 509-594-6119
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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 | P0331
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License Number State | TX
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