Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | K7963 | TX |
NPI | 1003965906 |
---|---|
Provider Name | Nabeel K Ahmed |
First Address | Tyler, TX 75701-2130 |
Second Address | Tyler, TX 75701-2130 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/01/2007 |
Last Update Date | 08/11/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
047138501 | (05) | TX |
2002214870 A | (05) | OK |
390006475 | RAILROAD MEDICARE (01) | |
G97559 | (02) |