Individual
ASAD IKRAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
713 GRAINGER ST, FORT WORTH, TX 76104-3261
(817) 336-3968
(817) 336-7817
Mailing address
713 GRAINGER ST, FORT WORTH, TX 76104-3261
(817) 336-3968
(817) 336-7817
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
290773
MA
390200000X
Student in an Organized Health Care Education/Training Program
290773
MA
390200000X
Student in an Organized Health Care Education/Training Program
MD2022-0007
NM
390200000X
Student in an Organized Health Care Education/Training Program
RS2017-1004
NM
Other
Enumeration date
11/22/2017
Last updated
06/20/2024
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