Provider Demographics
NPI:1225072663
Name:ALAM, S M GOLAM (MD)
Entity Type:Individual
Prefix:DR
First Name:S M GOLAM
Middle Name:
Last Name:ALAM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:MR
Other - First Name:GOLAM
Other - Middle Name:
Other - Last Name:ALAM
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 4449
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78502-4449
Mailing Address - Country:US
Mailing Address - Phone:956-362-8740
Mailing Address - Fax:956-362-8796
Practice Address - Street 1:5525 DOCTORS DR
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-5520
Practice Address - Country:US
Practice Address - Phone:956-362-8740
Practice Address - Fax:956-362-8795
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2023-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL9977207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX181205903Medicaid
TX181205903Medicaid