Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | Q9425 | TX |
Y | 2080P0214X | Pediatric Pulmonologist | Q9425 | TX |
NPI | 1174865646 |
---|---|
Provider Name | Dr. Brian Kelly Mahmood |
First Address | El Paso, TX 79902-4676 |
Second Address | Dallas, TX 75235-7701 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/03/2013 |
Last Update Date | 26/03/2019 |