MEDICARE: DR. TASNEEM MAHMOOD DDS

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	122300000X	Dentist	36596	TX
2	1223G0001X	General Practice Dentistry	36596	TX

General Provider Information

NPI Number	:	1851904148
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TASNEEM MAHMOOD DDS

Provider Business Mailing Address
First Line	:	3700 BUFFALO SPEEDWAY STE 310
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77098-3705
Country	:	US
Telephone Number	:	713-850-9699
Fax Number	:

Provider Business Practice Location Address
First Line	:	3700 BUFFALO SPEEDWAY STE 310
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77098-3705
Country	:	US
Telephone Number	:	713-850-9699
Fax Number	:

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

Provider Enumeration Date	:	08/26/2020
Last Update Date	:	04/14/2022

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