Basic Information
| Provider Information | |||||||||
| NPI: | 1174967087 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MAJEED | ||||||||
| FirstName: | AMMAR | ||||||||
| MiddleName: | |||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 434 SW WILSHIRE BLVD | ||||||||
| Address2: | |||||||||
| City: | BURLESON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 760285330 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8174471208 | ||||||||
| FaxNumber: | 8174471106 | ||||||||
| Practice Location | |||||||||
| Address1: | 434 SW WILSHIRE BLVD | ||||||||
| Address2: | |||||||||
| City: | BURLESON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 760285330 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8174471208 | ||||||||
| FaxNumber: | 8174471106 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/22/2013 | ||||||||
| LastUpdateDate: | 11/04/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/04/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 29950 | OK | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | R7267 | TX | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 200571250 A | 05 | OK | MEDICAID |