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Individual

DR. AMMAR MOIN AHMED

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
313 E 12TH ST, SUITE 101, AUSTIN, TX 78701-1954
(512) 324-9650
(512) 324-9653
Mailing address
1601 RIO GRANDE ST, SUITE 340, AUSTIN, TX 78701-1137
(512) 324-8960
(512) 324-8962

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
N4239
TX
207RA0000X
Adolescent Medicine (Internal Medicine) Physician
BP10029412
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
283582901
TX
05
283582902
TX
01
8CT175
BCBS
TX
Enumeration date
08/05/2007
Last updated
01/10/2013
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