| Burnaby Medical Group Llc | |
|
6909 Benjamin Way Colleyville TX 76034-1109 | |
| (405) 694-3989 | |
| Not Available |
| Full Name | Burnaby Medical Group Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 6909 Benjamin Way, Colleyville, Texas |
| Authorized Official Name and Position | Syed Tahsin Ahmed (MEMBER) |
| Authorized Official Contact | 4056943989 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Burnaby Medical Group Llc 6909 Benjamin Way Colleyville TX 76034-1109 Ph: (405) 694-3989 | Burnaby Medical Group Llc 6909 Benjamin Way Colleyville TX 76034-1109 Ph: (405) 694-3989 |
| NPI Number | 1104510577 |
|---|---|
| Provider Enumeration Date | 06/07/2023 |
| Last Update Date | 06/07/2023 |
| Medicare PECOS PAC ID | 2769843259 |
|---|---|
| Medicare Enrollment ID | O20230801000005 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104510577 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Syed Tashin Ahmed |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1477811321 PECOS PAC ID: 6800104274 Enrollment ID: I20151005001300 |
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