Basic Information
Provider Information
NPI: 1326449018
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: AHMED
FirstName: RAEES
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3406 COLLEGE ST STE 200
Address2:  
City: BEAUMONT
State: TX
PostalCode: 777014612
CountryCode: US
TelephoneNumber: 4098132332
FaxNumber: 4092320559
Practice Location
Address1: 3406 COLLEGE ST # 100
Address2:  
City: BEAUMONT
State: TX
PostalCode: 777014612
CountryCode: US
TelephoneNumber: 4098131677
FaxNumber: 4099511691
Other Information
ProviderEnumerationDate: 09/12/2014
LastUpdateDate: 05/04/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 05/04/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000XQ1343TXN Allopathic & Osteopathic PhysiciansInternal Medicine 
207RC0200XQ1343TXY Allopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine

No ID Information.


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