1952354938 NPI number — MR. MUHAMAD EMAD AMHAN M.D./P.A.

Table of content: MR. MUHAMAD EMAD AMHAN M.D./P.A. (NPI 1952354938)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1952354938 NPI number — MR. MUHAMAD EMAD AMHAN M.D./P.A.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
AMHAN
Provider First Name:
MUHAMAD
Provider Middle Name:
EMAD
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
M.D./P.A.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
AMHAN
Provider Other First Name:
MUHAMAD
Provider Other Middle Name:
EMAD
Provider Other Name Prefix Text:
MR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.D./P.A.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1952354938
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/29/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2705 N MASTERS DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SHERMAN
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75090
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
903-813-8270
Provider Business Mailing Address Fax Number:
903-813-8470

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2605 N MASTERS DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SHERMAN
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75090-2508
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
903-813-8270
Provider Business Practice Location Address Fax Number:
903-813-8470
Provider Enumeration Date:
05/18/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207LP2900X , with the licence number:  K6527 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0074MP . This is a "BCBS PROVIDER #" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".