Individual
MAHMUDA NUSRAT FARHA AHMED
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O
Contact information
Practice address
1500 S MAIN ST, FORT WORTH, TX 76104-4917
(817) 704-3431
Mailing address
1500 S MAIN ST, FORT WORTH, TX 76104-4917
(817) 704-3431
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
R9563
TX
390200000X
Student in an Organized Health Care Education/Training Program
BP10055954
TX
Other
Enumeration date
04/04/2016
Last updated
05/02/2019
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