Provider Demographics
NPI:1316118300
Name:AHMAD, SHEMA RIAZ (MD)
Entity type:Individual
Prefix:
First Name:SHEMA
Middle Name:RIAZ
Last Name:AHMAD
Suffix:
Gender:F
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:PO BOX 844658
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-4658
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:425 UNIVERSITY BLVD
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78665-1053
Practice Address - Country:US
Practice Address - Phone:512-509-0200
Practice Address - Fax:512-509-0285
Is Sole Proprietor?:No
Enumeration Date:2008-03-18
Last Update Date:2020-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS18961207RE0101X
TXR2517207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS04478840Medicaid
MSP01330237OtherRAILROAD MEDICARE PTAN
MSP01330237OtherRAILROAD MEDICARE PTAN
MS04478840Medicaid
MS302I467197Medicare PIN