Provider Demographics
NPI:1194715656
Name:MASOOD, ASIF (MD)
Entity type:Individual
Prefix:
First Name:ASIF
Middle Name:
Last Name:MASOOD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1310 PALUXY RD
Mailing Address - Street 2:
Mailing Address - City:GRANBURY
Mailing Address - State:TX
Mailing Address - Zip Code:76048-5655
Mailing Address - Country:US
Mailing Address - Phone:352-428-0898
Mailing Address - Fax:
Practice Address - Street 1:850 ED HALL DR
Practice Address - Street 2:
Practice Address - City:KAUFMAN
Practice Address - State:TX
Practice Address - Zip Code:75142-1861
Practice Address - Country:US
Practice Address - Phone:972-932-7349
Practice Address - Fax:972-932-5557
Is Sole Proprietor?:No
Enumeration Date:2005-10-26
Last Update Date:2025-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME100913208M00000X, 207Q00000X
AZ67476207Q00000X, 208M00000X
NY234025-1207Q00000X
TXU8389207Q00000X
NY234025208M00000X
IL036163719208M00000X
TN64838208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL000458600Medicaid
FL46362OtherBCBS
NY2601027Medicaid
FL46362OtherBCBS
NYRA4903Medicare ID - Type UnspecifiedMEDICARE
FL000458600Medicaid
FLAL520ZMedicare PIN