Provider Demographics
NPI:1073657318
Name:SYED J. UMER, MD, PA
Entity Type:Organization
Organization Name:SYED J. UMER, MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SYED
Authorized Official - Middle Name:JAVED
Authorized Official - Last Name:UMER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-681-6176
Mailing Address - Street 1:7234 HOVINGHAM
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78257-1364
Mailing Address - Country:US
Mailing Address - Phone:210-681-6176
Mailing Address - Fax:210-681-6157
Practice Address - Street 1:11130 CHRISTUS HILLS
Practice Address - Street 2:SUITE 207 MEDICAL PLAZA 3
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78251
Practice Address - Country:US
Practice Address - Phone:210-681-6176
Practice Address - Fax:210-681-6157
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-19
Last Update Date:2019-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK5232207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1073657318OtherNPI
TX186799601Medicaid
TX186799601Medicaid