MEDICARE: DR. ALEX A EHSAN 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	207RX0202X	Medical Oncology Physician	M6595	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	P00608951	OTHER	TX	RAILROAD MEDICARE

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
3	8AA599	OTHER	TX	BCBS

General Provider Information

NPI Number	:	1982883948
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALEX A EHSAN M.D,

Provider Business Mailing Address
First Line	:	PO BOX 911230
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75391-1230
Country	:	US
Telephone Number	:	972-997-8000
Fax Number	:	972-234-2987

Provider Business Practice Location Address
First Line	:	2800 HIGHWAY 75 NORTH
Second Line	:
City	:	SHERMAN
State	:	TX
Zip	:	75090-0504
Country	:	US
Telephone Number	:	903-892-9455
Fax Number	:	903-892-4910

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

Provider Enumeration Date	:	10/26/2007
Last Update Date	:	08/15/2014

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Directions to “ DR. ALEX A EHSAN M.D,” Practice Location

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