MEDICARE: MANAF G. AHMAD 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	2080P0204X	Pediatric Emergency Medicine (Pediatrics) Physician	K2395	TX
2	208000000X	Pediatrics Physician	K2395	TX
3	2080P0006X	Developmental - Behavioral Pediatrics Physician	K2395	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

General Provider Information

NPI Number	:	1932191426
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MANAF G. AHMAD MD

Provider Business Mailing Address
First Line	:	757 SOMERSET COMMONS LN
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77055-1927
Country	:	US
Telephone Number	:	337-380-4764
Fax Number	:	281-859-0175

Provider Business Practice Location Address
First Line	:	15322 COPPER GROVE BLVD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77095-2293
Country	:	US
Telephone Number	:	281-859-7596
Fax Number	:	281-859-0175

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

Provider Enumeration Date	:	08/19/2005
Last Update Date	:	11/01/2024

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