Provider Demographics
NPI:1336455260
Name:ATIQ, OMAIR (MD)
Entity type:Individual
Prefix:DR
First Name:OMAIR
Middle Name:
Last Name:ATIQ
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 1:2800 E BROAD ST STE 304
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:76063-6412
Mailing Address - Country:US
Mailing Address - Phone:817-477-5500
Mailing Address - Fax:817-453-5503
Practice Address - Street 1:2800 E BROAD ST STE 304
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:TX
Practice Address - Zip Code:76063-6412
Practice Address - Country:US
Practice Address - Phone:817-477-5500
Practice Address - Fax:817-453-5503
Is Sole Proprietor?:No
Enumeration Date:2010-08-30
Last Update Date:2025-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXT1286207RG0100X
ALMD34837207RG0100X
390200000X
ALL3213R207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine