Provider Demographics
NPI:1699864306
Name:MAHOOD, ALLAN (MD)
Entity type:Individual
Prefix:
First Name:ALLAN
Middle Name:
Last Name:MAHOOD
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:PO BOX 863534
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32886-3534
Mailing Address - Country:US
Mailing Address - Phone:904-805-1300
Mailing Address - Fax:904-805-1302
Practice Address - Street 1:ONE ST MARKS PLACE
Practice Address - Street 2:
Practice Address - City:LAGRANGE
Practice Address - State:TX
Practice Address - Zip Code:78945-2040
Practice Address - Country:US
Practice Address - Phone:904-805-1300
Practice Address - Fax:904-805-1302
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2007-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH6400207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8H4093OtherBCBS
TXP00162025OtherRAILROAD MEDICARE
TX8H4093OtherBCBS
TX8D7063Medicare PIN