MEDICARE: MUHAMMAD ASIM MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RG0100X	Gastroenterology Physician	K9717	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	0085LY	OTHER	BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	201476795	OTHER	TAX ID

General Provider Information

NPI Number	:	1134130628
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MUHAMMAD ASIM MD

Provider Business Mailing Address
First Line	:	PO BOX 93477
Second Line	:
City	:	SOUTHLAKE
State	:	TX
Zip	:	76092-9998
Country	:	US
Telephone Number	:	214-415-6845
Fax Number	:	888-770-6360

Provider Business Practice Location Address
First Line	:	609 MEDICAL CENTER DR
Second Line	:	SUITE 2600
City	:	DECATUR
State	:	TX
Zip	:	76234-3836
Country	:	US
Telephone Number	:	214-415-6845
Fax Number	:	888-770-6360

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/10/2006
Last Update Date	:	12/21/2022

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Directions to “ MUHAMMAD ASIM MD” Practice Location

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