Basic Information
| Provider Information | |||||||||
| NPI: | 1902837560 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | IQBAL | ||||||||
| FirstName: | AHMED | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1909 SHOOTING STAR LN | ||||||||
| Address2: | |||||||||
| City: | SOUTHLAKE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 760926934 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8179940128 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1901 N MACARTHUR BLVD | ||||||||
| Address2: | |||||||||
| City: | IRVING | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750612220 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9725798338 | ||||||||
| FaxNumber: | 9725793972 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/05/2006 | ||||||||
| LastUpdateDate: | 11/10/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207PE0004X | J9104 | TX | N | Allopathic & Osteopathic Physicians | Emergency Medicine | Emergency Medical Services | 207R00000X | J9104 | TX | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.