Individual
TARIQ AHMED
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1049 N PINE RD, OLLA, LA 71465-4826
(318) 495-0755
(318) 495-0781
Mailing address
1102 N PINE RD, OLLA, LA 71465-4804
(318) 495-3131
(318) 495-0750
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
12117R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12117R
LICENSE NUMBER
LA
05
—
1533661
—
LA
Enumeration date
08/30/2006
Last updated
05/10/2019
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