Provider Demographics
NPI:1134298201
Name:ALJAMAL, HOUSSAM OMAR (DC)
Entity Type:Individual
Prefix:DR
First Name:HOUSSAM
Middle Name:OMAR
Last Name:ALJAMAL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 N COIT RD STE 250
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-5485
Mailing Address - Country:US
Mailing Address - Phone:972-792-7500
Mailing Address - Fax:972-792-8300
Practice Address - Street 1:300 N COIT RD STE 250
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-5485
Practice Address - Country:US
Practice Address - Phone:972-792-7500
Practice Address - Fax:972-792-8300
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9303111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXU91514Medicare UPIN
TX00111HMedicare ID - Type UnspecifiedCHIROPRACTIC