Provider Demographics
NPI:1932426236
Name:ISLAM, MAHMUDA (MD,)
Entity type:Individual
Prefix:DR
First Name:MAHMUDA
Middle Name:
Last Name:ISLAM
Suffix:
Gender:F
Credentials:MD,
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 845347
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-5347
Mailing Address - Country:US
Mailing Address - Phone:214-648-9741
Mailing Address - Fax:214-648-9531
Practice Address - Street 1:501 MIDWESTERN PKWY E
Practice Address - Street 2:
Practice Address - City:WICHITA FALLS
Practice Address - State:TX
Practice Address - Zip Code:76302-2302
Practice Address - Country:US
Practice Address - Phone:940-766-3551
Practice Address - Fax:940-716-5773
Is Sole Proprietor?:No
Enumeration Date:2010-04-26
Last Update Date:2019-01-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXP7287208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX314487YNDPMedicare PIN