MEDICARE: AMBREEN ASLAM M.D.

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	208000000X	Pediatrics Physician	J5664	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1558361741
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMBREEN ASLAM M.D.

Provider Business Mailing Address
First Line	:	20863 SWEETGLEN DR.
Second Line	:
City	:	PORTER
State	:	TX
Zip	:	77365-6391
Country	:	US
Telephone Number	:	832-237-8882
Fax Number	:	832-237-8886

Provider Business Practice Location Address
First Line	:	11811 FALLBROOK DR.
Second Line	:	SUITE B-2
City	:	HOUSTON
State	:	TX
Zip	:	77065-3600
Country	:	US
Telephone Number	:	832-237-8882
Fax Number	:	832-237-8886

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

Provider Enumeration Date	:	07/28/2005
Last Update Date	:	01/21/2015

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