Provider Demographics
NPI:1932191426
Name:AHMAD, MANAF G (MD)
Entity type:Individual
Prefix:
First Name:MANAF
Middle Name:G
Last Name:AHMAD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Last Name:
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Mailing Address - Street 1:757 SOMERSET COMMONS LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77055-1927
Mailing Address - Country:US
Mailing Address - Phone:337-380-4764
Mailing Address - Fax:281-859-0175
Practice Address - Street 1:15322 COPPER GROVE BLVD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77095-2293
Practice Address - Country:US
Practice Address - Phone:281-859-7596
Practice Address - Fax:281-859-0175
Is Sole Proprietor?:No
Enumeration Date:2005-08-19
Last Update Date:2024-11-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXK23952080P0204X, 208000000X, 2080P0006X, 2080P0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2080P0204XAllopathic & Osteopathic PhysiciansPediatricsPediatric Emergency Medicine
No2080P0006XAllopathic & Osteopathic PhysiciansPediatricsDevelopmental - Behavioral Pediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1996629Medicaid
G18556Medicare UPIN
LAG18556Medicare UPIN