Basic Information
| Provider Information | |||||||||
| NPI: | 1750661880 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | AHMED | ||||||||
| FirstName: | ADNAN | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2306 HOLLAND AVE | ||||||||
| Address2: | |||||||||
| City: | EDINBURG | ||||||||
| State: | TX | ||||||||
| PostalCode: | 785390116 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3472431952 | ||||||||
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| Practice Location | |||||||||
| Address1: | 5019 S MCCOLL RD | ||||||||
| Address2: | |||||||||
| City: | EDINBURG | ||||||||
| State: | TX | ||||||||
| PostalCode: | 785398080 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9563225765 | ||||||||
| FaxNumber: | 9566031240 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/20/2011 | ||||||||
| LastUpdateDate: | 10/06/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/06/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | P8009 | TX | Y | Allopathic & Osteopathic Physicians | Pediatrics |
ID Information
| ID | Type | State | Issuer | Description | 350075304 | 05 | TX | MEDICAID |