Provider Demographics
NPI:1104840545
Name:LONE, JAMAL QAMAR (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMAL
Middle Name:QAMAR
Last Name:LONE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:8210 WALNUT HILL LN STE 312
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-4419
Mailing Address - Country:US
Mailing Address - Phone:214-238-3074
Mailing Address - Fax:214-238-3608
Practice Address - Street 1:8210 WALNUT HILL LN STE 312
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231
Practice Address - Country:US
Practice Address - Phone:214-238-3074
Practice Address - Fax:214-238-3608
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM4304207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX351461401Medicaid
TX1-407396-TCOtherCERTIFICATE OF INSURANCE
TXM4304OtherSTATE MEDICAL LICENSE
TX20600852OtherDRIVERS LICENSE
TX351460601Medicaid
0-640-994-0OtherECFMG
0-640-994-0OtherECFMG