| Jiaul Ahsan Pllc | |
|
99 Regency Pkwy Ste 305 Mansfield TX 76063-7820 | |
| (817) 400-0705 | |
| Not Available |
| Full Name | Jiaul Ahsan Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 99 Regency Pkwy Ste 305, Mansfield, Texas |
| Authorized Official Name and Position | Jiaul Ahsan (OWNER) |
| Authorized Official Contact | 8174000705 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jiaul Ahsan Pllc 99 Regency Pkwy Ste 305 Mansfield TX 76063-7820 Ph: (817) 400-0705 | Jiaul Ahsan Pllc 99 Regency Pkwy Ste 305 Mansfield TX 76063-7820 Ph: (817) 400-0705 |
| NPI Number | 1366857963 |
|---|---|
| Provider Enumeration Date | 06/23/2014 |
| Last Update Date | 06/23/2014 |
| Medicare PECOS PAC ID | 8921224726 |
|---|---|
| Medicare Enrollment ID | O20140731001898 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366857963 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | K9208 (Texas) | Primary |
| Provider Name | Jiaul Ahsan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114956877 PECOS PAC ID: 3274673082 Enrollment ID: I20091229000243 |
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