Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RH0003X | Hematology & Oncology | L7802 | TX |
Y | 207RX0202X | Medical Oncology | L7802 | TX |
NPI | 1164464152 |
---|---|
Provider Name | Dr. Khalid Mahmood |
First Address | Dallas, TX 75391-1230 |
Second Address | Webster, TX 77598-4219 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/06/2006 |
Last Update Date | 25/09/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
164731503 | (05) | TX |
164731505 | (05) | TX |
164731508 | (05) | TX |
164731509 | (05) | TX |
8R1593 | BLUE CROSS OF TEXAS (01) | TX |
G38788 | (02) |